Coding Edits Specialist - Remote

Lifepoint Health • Brentwood, TN

1d • Remote

About The Position

The Coding Edits Specialist assigns diagnosis and procedure codes for episodes of care across emergency department, same-day surgery, outpatient clinic, observation, inpatient OB newborn, and specialty clinic encounters. The role follows coding conventions, guidelines, hospital policies, and CMS billing requirements, analyzes questionable documentation, and works to resolve identified issues. The specialist may verify, edit, or enter charges based on documentation or payer/billing information.

The position maintains coding accuracy and productivity standards, follows coding workflows and compliance review processes, submits physician queries when documentation needs clarification, and collaborates with physicians, nurses, medical staff, and hospital employees. The specialist may assist with training and reviewing other coders’ work, make recommendations to the supervisor, and support department goals. The role also requires continuing education, credential renewal as applicable, completion of compliance courses, adherence to ethical coding and attendance policies, and protection of patient and employee confidentiality. This is a full-time remote position with a Monday-Friday schedule; employees may set their own schedule and work 40 hours per week.

Requirements

• Associate degree in a health-related field is preferred.
• One year of outpatient coding experience in an acute care hospital is preferred.
• CCA, CPC, CCS, or RHIT certification is preferred.
• Must be authorized to work in the United States without employer sponsorship.

Nice To Haves

• Associate degree in a health-related field.
• One year of outpatient coding experience in an acute care hospital.
• Certified Coding Associate (CCA), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Registered Health Information Technician (RHIT) credential.

Responsibilities

• Assign diagnosis and procedure codes for emergency department, same-day surgery, outpatient clinic, observation, inpatient OB newborn, and specialty clinic encounters according to coding conventions, guidelines, and hospital policy.
• Use ICD-10-CM, CPT, and HCPCS coding systems according to CMS hospital billing requirements.
• Analyze questionable documentation and resolve identified issues.
• Achieve and maintain 95% accuracy on quality reviews and assigned productivity standards.
• Apply knowledge of APCs, OPPS, NCCI guidelines, Local and National Coverage Decisions, and other medical necessity and compliance guidelines.
• Verify, edit, and/or enter charges based on documentation or payer/billing information as needed.
• Maintain knowledge of rules, regulations, policies, laws, and guidelines affecting the coding area.
• Follow service-type coding workflows, including addressing compliance reviews.
• Submit physician queries when documentation needs clarification.
• Maintain productive working relationships with physicians, nurses, medical staff, and hospital employees.
• Assist with training and reviewing other coders’ work for accuracy and efficiency as needed.
• Make recommendations to the supervisor and implement and monitor results as appropriate to support department goals.
• Seek advice and guidance as needed to ensure proper understanding.
• Assist others with responsibilities and adjust work schedules to meet department needs.
• Use independent discretion and decision-making while working remotely.
• Attend required educational webinars, conference calls, coding seminars, and formal or informal coding discussions.
• Maintain coding education hours and renew annual coding credentials as applicable.
• Complete assigned compliance courses within the designated period.
• Follow AHIMA’s Code of Ethics and Standards of Ethical Coding and LifePoint’s Attendance Policy, while maintaining patient and employee confidentiality.
• Perform other related tasks or responsibilities as assigned.

Benefits

• Multiple levels of medical, dental, and vision coverage for full-time and part-time employees.
• Life, accident, critical illness, and hospital indemnity insurance.
• Short- and long-term disability coverage.
• Paid family leave and paid time off.
• Higher education and certification tuition assistance.
• Loan assistance.
• 401(k) retirement package with company match.
• Mental, physical, and financial wellness programs, including free gym memberships, virtual care appointments, mental health services, and discount programs.
• Ongoing learning and career advancement opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree