[Hiring] Certified Medical Coding Specialist @SolutionHealth

Role Description

The Coding Specialist – Professional Based (PB) is responsible for analyzing professional (physician and advanced practice provider) encounters and related documentation to assign accurate ICD-10-CM, CPT, and HCPCS codes. This role ensures compliance with current coding guidelines, regulatory requirements, and payer-specific rules while supporting timely and compliant coding to optimize reimbursement and minimize denials. The Coding Specialist PB collaborates closely with providers, clinical staff, and revenue cycle partners and issues queries as needed to ensure documentation supports accurate code assignment.

• Review and analyze professional medical records, including office visits, hospital-based professional services, and outpatient encounters
• Assign accurate ICD-10-CM, CPT, and HCPCS codes
• Apply appropriate CPT modifiers, units, place of service indicators, and payer-specific billing rules
• Abstract and enter coded data into Epic and other professional billing and coding systems
• Ensure compliance with official coding guidelines, regulatory requirements, payer policies, and organizational standards
• Maintain a minimum coding accuracy rate of 95% and meet established productivity benchmarks
• Review, investigate, and resolve claim edits and coding-related errors
• Validate provider documentation and query providers for clarification or additional detail when needed
• Serve as a subject matter expert for professional coding, including E/M services, procedure coding, and modifier usage
• Collaborate with providers, clinical staff, educators, and revenue cycle teams to resolve coding and documentation issues
• Monitor and communicate coding and documentation trends impacting professional billing and compliance
• Stay current on coding updates, regulatory changes, and professional billing requirements
• Participate in audits, education, training, and continuous improvement initiatives
• Perform other duties as assigned

Qualifications

• High School diploma or equivalent required
• Associate degree in Health Information Management or a closely related field preferred
• Certification (Required at Time of Hire):
• Certified Coding Specialist (CCS)
• Certified Professional Coder (CPC)
• Certified Coding Specialist – Physician-Based (CCS-P)
• Additional HIM certifications (RHIT, RHIA) preferred

Requirements

• Minimum of two (2) years of professional coding experience in a multispecialty physician setting
• Experience with ICD-10-CM, CPT, and HCPCS coding systems

Knowledge & Skills

• Knowledge of professional coding guidelines and compliant coding practices
• Knowledge of medical terminology, anatomy, physiology, and regulatory compliance (CMS, HIPAA)
• Proficiency with Epic and coding/encoder software preferred
• Strong analytical, problem-solving, written, and verbal communication skills

Benefits

• Health, dental, prescription, and vision coverage for full-time & part-time employees
• Life insurance
• Short- and long-term disability
• Flexible Spending Accounts (FSA)
• Competitive pay
• Tuition Reimbursement
• Nursing Student Loan Paydown Program
• 403(b) Retirement Savings Plan
• Education & Paid training courses for continued career progression
• & So much more!

Work Shift

Full Time | 40 hours/week | Monday thru Friday | Remote

SolutionHealth is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, disability status, veteran status, or any other characteristic protected by law.