Revenue Cycle Coding Specialist

HealthPartners•United States,

3d•$26 - $39

About The Position

The Revenue Cycle Coding Specialist abstracts and enters charges for provider services delivered in hospital inpatient and outpatient settings, ambulatory surgery, and other system-wide outpatient facilities. The specialist assigns appropriate CPT, HCPCS, and ICD-10 codes, modifiers, and fees in accordance with billing requirements, third-party payer regulations, and applicable contracts to support accurate and timely reimbursement. The role also includes retrospective chart documentation audits related to denied claims, provider requests, and patient complaints. The specialist reviews documentation to confirm it supports clinician-selected charges, provides coding feedback and education, works with clinicians and department representatives on complex coding and billing issues, and supports charting tools such as smart sets, templates, and preference lists. The role also involves denial review, compliance and audit collaboration, clinician onboarding support, and coordination with coding education and data analysis teams.

Requirements

Completion of a coding education program, a degree in Health Information Management or a related field, or equivalent coding experience.
An approved coding certification: CCA, COC, CCS, CPC, CCS-P, RHIT, or RHIA.
Knowledge of CPT, HCPCS, and ICD-10-CM coding guidelines, rules, and regulations.
Knowledge of anatomy, physiology, basic disease processes, and medical terminology.
Intermediate knowledge of Microsoft Office Suite.
Ability to work independently and apply time-management and critical-thinking skills.
Strong decision-making skills.

Nice To Haves

One year of coding experience.
Epic experience.
Experience working with online coding resources and related software programs.
Strong E&M coding experience.
Ability to present and communicate information professionally and confidently in individual or group settings.

Responsibilities

Confirm documentation supports clinician-selected charges and provide feedback.
Assign accurate CPT, HCPCS, and ICD-10-CM codes, modifiers, and fees according to billing and payer regulations.
Complete CCI/LCD/NCD edits and Epic coding edits, using coding-associated charge review work queues, strategies, and rules.
Maintain current knowledge of annual coding changes, regulations, and legislative communications affecting coding and billing practices.
Evaluate annual code changes for liaison specialties and communicate their impact appropriately.
Perform and understand risk-adjustment models and data validation according to coding guidelines and best practices.
Provide clinicians with feedback and education based on coding trends, chart reviews, and other opportunities.
Work with clinicians and medical department representatives to discuss complex billing and coding issues.
Assist with the content and use of charting tools, including smart sets, templates, and preference lists.
Work coding-related denials and provide feedback to clinicians or departments based on denial trends.
Conduct retrospective coding audits related to denied claims, clinician requests, and patient complaints.
Work closely with Compliance Operations and Internal Auditing teams, including on annual provider reviews.
Partner with Coding Education and Data Analyst teams on documentation and coding reviews, coding audits, and feedback for new and existing clinicians.
Assist with strategies for New Clinician Orientation and onboarding operational leaders on mid-revenue-cycle workflows.
Perform other duties as assigned.