Role Description
Independently perform complex, specialty-specific professional fee coding (CPT/HCPCS and ICD-10-CM) for physician services rendered in both office and hospital settings, ensuring expert application of modifiers and E/M guidelines, or:
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Perform entry-level facility coding for simple outpatient encounters (e.g., diagnostic imaging, labs) and basic inpatient services (e.g., uncomplicated admissions, short stays) using ICD-10-CM and ICD-10-PCS, where applicable.
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Ensure all coding adheres strictly to official guidelines (e.g., provided by AAPC or AHIMA), federal regulations (CMS), and organizational compliance standards.
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Identify the need for formal clinical queries for documentation clarification when necessary for professional or facility records.
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Maintain high accuracy and productivity standards appropriate to the complexity of the assigned workload.
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May provide informal guidance to new coding staff on professional coding nuances.
Qualifications
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An active coding certification issued by the American Academy of Coders (AAPC) OR American Health Information Management Association (AHIMA); dual certifications preferred.
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Completion of an accredited medical coding or HIM program (or equivalent experience).
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High School Diploma or Equivalent required.
Requirements
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Minimum of 3-5 years of direct professional fee coding experience in a multi-specialty environment is required.
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Experience with professional procedural coding (e.g., surgical, interventional procedures) is preferred.
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Experience with Epic or similar electronic health record systems is required.
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Proficient knowledge of medical terminology, anatomy, and pathophysiology.
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Advanced proficiency in CPT/HCPCS and ICD-10-CM/PCS coding systems.
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Basic understanding of facility payment methodologies (MS-DRGs) as they apply to simple encounters.
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Strong analytical skills, attention to detail, and ability to context-switch between different coding guidelines.
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Ability to work independently, manage a varied workload, and meet deadlines in a fast-paced environment.
Benefits
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Paid Time Off programs.
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Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability.
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Flexible Spending Accounts for eligible health care and dependent care expenses.
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Family benefits such as adoption assistance and paid parental leave.
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Defined contribution retirement plans with employer match and other financial wellness programs.
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Educational Assistance Program.