Hospital Coding Specialist
About The Position
The Senior Hospital Coding Specialist is responsible for accurate and compliant coding of both facility (hospital) and professional (physician/provider) services across multiple specialties. This position reviews, abstracts, and assigns ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, and modifier codes for multiple specialties, with surgery being the primary specialty. The role ensures compliance with federal regulations, payer requirements, coding guidelines, and organizational policies while supporting revenue cycle integrity and optimal reimbursement. The ideal candidate possesses advanced coding expertise in multiple specialties, including surgery, and has extensive experience utilizing major hospital electronic medical record (EMR) systems and coding encoder software.
Requirements
- High School Diploma or GED
- Active credentials such as CPC, CCS, CIC, COC, or CRC (coding certification must be role-aligned)
- 5+ years of experience in hospital coding for professional fee and facility
- Demonstrated experience coding both inpatient and outpatient hospital encounters
- Experience coding multiple clinical specialties, including at least one surgical specialty
- Experience with at least 2 major hospital EMR platforms (Epic, Cerner, Oracle Health, Meditech, TruBridge, CPSI Encoder)
- Experience with at least 2 major coding encoders (3M Codefinder, 360 Encompass, Optum EncoderPro, TruCode Encoder, Dolbey Fusion CAC)
- Strong working knowledge of ICD-10-CM, PCS, CPT, HCPCS, modifiers, and E/M guidelines
- Experience with encoder/grouper tools, EHR workflows, and claim edit concepts (e.g., NCCI)
- Experience coding without encoder/grouper tools
- Working knowledge of HIPAA, documentation standards, and audit expectations
- Ability to work independently in a remote, metric-driven environment
Nice To Haves
- Associate's degree in Health Information Management, Health Information Technology, Nursing, or related healthcare field preferred
- RHIT or RHIA preferred
- Speciality coding experience (ER, IP, OBS, Swing) strongly preferred
- Experience with coding audits, second-level reviews, and coder coaching preferred
- Familiarity with denial management, payer policy research, and appeals support preferred
Responsibilities
- Review and analyze clinical documentation to assign accurate diagnosis, procedure, and service codes for facility and professional billing
- Code inpatient, outpatient, emergency department, observation, clinic, and ambulatory surgery encounters
- Assign ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, and applicable modifiers in accordance with official coding guidelines
- Ensure coding accuracy, completeness, and compliance with CMS, Medicare, Medicaid, commercial payer, and regulatory requirements
- Query providers when documentation lacks specificity necessary for accurate code assignment
- Participate in coding quality reviews, audits, and education initiatives
- Maintain productivity and quality standards established by the organization
- Research coding regulations, payer policies, and reimbursement guidelines
- Assist in denial management, appeals, charge capture reviews, and revenue cycle optimization efforts
- Support onboarding and mentoring of junior coding staff when assigned
- Assist in other duties as assigned
Benefits
- Access to a 401(k) Retirement Savings Plan.
- Comprehensive Medical, Dental, and Vision Coverage.
- Paid Time Off.
- Paid Holidays.
- Pet Care Coverage
- Employee Assistance Program (EAP)
- discounted services
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
