Coding Quality Specialist 3 - PM&R Coder
About The Position
Accurate documentation and coding are essential to delivering high-quality patient care, supporting compliance, and ensuring the financial health of a leading academic medical center. This role offers an opportunity to make a meaningful impact by serving as a trusted coding quality resource for a highly specialized Physical Medicine & Rehabilitation practice. As a Coding Quality Specialist 3 supporting PM&R Musculoskeletal services, you will leverage your expertise in coding, auditing, and clinical documentation review to ensure accurate capture of complex services. This position will focus primarily on Encompass Hospital Rehabilitation coding. An additional focus will involve Wound Care coding. This fully remote position is ideal for an experienced professional who enjoys analytical work, collaboration with providers, and driving excellence in coding quality and compliance.
Requirements
- High School Diploma or GED required.
- 5+ years of relevant coding experience required.
- Certified Professional Coder (CPC) required.
Nice To Haves
- Experience with Hospital Rehabilitation and Wound Care coding preferred.
Responsibilities
- Perform detailed coding quality reviews and audits for PM&R Musculoskeletal services (along with additional services to include Encompass Hospital Rehabilitation- and Wound Care coding.
- Apply expert knowledge of CPT, ICD-10-CM, modifier usage, NCCI edits, medical necessity requirements, and payer-specific guidelines.
- Review and validate Evaluation & Management (E/M) services and complex procedural documentation.
- Accurately assign and validate codes for: Musculoskeletal services, Pain management procedures, Injections and aspirations, Trigger point injections, Botulinum toxin procedures, EMG/NCS services, Epidural and facet procedures, Other interventional pain management services.
- Ensure appropriate linkage of diagnoses to procedures and support diagnosis specificity requirements.
- Identify documentation inconsistencies, omissions, and opportunities for provider clarification.
- Determine when provider queries are warranted and facilitate clear, compliant communication.
- Partner with coding, compliance, operational, and clinical teams to promote coding accuracy and quality improvement.
- Serve as a subject matter resource for PM&R coding practices and documentation standards.
Benefits
- Medical, Dental, and Vision Insurance
- Generous Paid Time Off
- Retirement Savings
- Long-term and Short-term Disability
- Health Saving Plans, and Flexible Spending Accounts
- Certification and Education Support
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
