Role Description
We are seeking a detail-oriented and experienced RCM Coding Specialist with CPC (Certified Professional Coder) certification to join our Revenue Cycle Management team. This role is responsible for accurate and timely medical coding in accordance with current coding guidelines, payer requirements, and company standards. The ideal candidate has strong analytical skills, in-depth knowledge of CPT, ICD-10, and HCPCS codes, and a commitment to ensuring compliance and optimizing reimbursement.
Responsibilities
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Serve as a medical coding subject matter expert who can effectively work with other staff to impart best practices related to revenue cycle management/coding within a telehealth setting.
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Review and abstract clinical documentation to assign appropriate CPT, ICD-10, and HCPCS codes.
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Ensure coding accuracy to optimize reimbursement while maintaining compliance with federal regulations, payer policies, and internal protocols.
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Perform regular audits of coded data to ensure quality and identify opportunities for education or process improvement.
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Stay current with industry changes including coding updates, payer guidelines, and regulatory requirements (e.g., CMS, HIPAA).
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Support RCM team in coding-related appeals or re-submissions.
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Maintain strict confidentiality of all patient, provider, and organizational data.
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Identify problem areas and trends encountered while working with any team or department and communicate findings to management.
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Remain proficient in the use of specific applications related to the coding teamβs function, i.e. billing systems, EMRs, internal portals, team communication tools, etc.
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Other duties as assigned.
Qualifications
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Required: CPC or CPC-A (AAPC). Additional certifications (e.g., CRC, CPC-H) is a plus.
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High school diploma or equivalent required.
Requirements
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2β3+ years of professional coding experience, preferably in Revenue Cycle Management.
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Experience with coding audits or quality assurance processes.
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Experience across multiple specialties.
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Experience with Candid Health billing software a plus.
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Proficient in CPT, ICD-10, and HCPCS coding systems.
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Strong knowledge of medical terminology, anatomy, and physiology.
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Intermediate knowledge of revenue cycle processes and best practices.
Skills & Attributes
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Strong organizational skills, time management, and attention to detail.
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Self-motivated and able to work autonomously, multitask, and shift priorities quickly.
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Sound judgment and reliable follow-through on deadlines.
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Excellent written and verbal communication skills.