10/6/2025
No location specified
About the position Responsibilities • Utilizing 3M, CPT, and ICD-10-CM coding books/software to assign CPT and/or ICD-10-CM codes to medical services or charges. • Completing required research to ensure compliance with CCI edits – CPT and ICD-10 coding standards. • Utilizing EPIC workflow to review account CCI edits and resolve as appropriate. • Performing charge reconciliations to ensure all charges are being captured. • Maintaining updated knowledge of coding requirements, including continuing education and certification renewal. • Reviewing and performing necessary coding and billing corrections for all insurance coding and medical necessity denials. • Assisting the billing staff with coding questions. • Consistently meeting the department specific standards for quantity standard. • Consistently coding at a 95% accuracy rate or better (quality standard). • Utilizing Internet and other resources to research newly identified diagnosis and/or other procedures. • Researching CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy. • Acting as a liaison between the denials team, billers, clinical staff, and leadership in resolving billing and reimbursement issues. • Conducting billing and coding compliance documentation review, which may include review of out-patient medical records to determine appropriateness of procedure and diagnosis coding, as well as evaluation and management coding. • Conducting analysis and applying state and federal healthcare or related regulations to different questions, projects, or inquiries. Requirements • Proficient in using 3M, CPT, and ICD-10-CM coding books/software. • Strong understanding of CCI edits and coding standards. • Experience with EPIC workflow for account management. • Knowledge of medical billing and coding compliance documentation. • Ability to conduct research on coding discrepancies and newly identified diagnoses. Nice-to-haves • Certification in coding (CPC, CCS, etc.). • Experience in a healthcare setting, particularly in patient accounts or billing. • Familiarity with federal healthcare regulations. Benefits • Opportunity for remote work after initial training period based on productivity levels. • Collaborative work environment with a focus on diversity, equity, and inclusion. Apply tot his job