Professional Coding Specialist II - Edits
Core
Review clinical documentation to assign accurate diagnosis and procedure codes, ensuring compliant billing and reimbursement across inpatient and outpatient encounters.
Role type
Medical Coding Specialist
Builds
Accurate medical claims and compliant billing records
Domain
Healthcare / Medical Billing & Coding
Required skills
ICD-10 coding, CPT coding, modifier application, medical terminology, anatomy and physiology knowledge, documentation review, claim resolution, coding audits, regulatory compliance
Preferred skills
Physician-office coding experience, Hospitalist and Intensivist specialty knowledge
Technologies
Electronic medical records, spreadsheets
Responsibilities
Review and interpret medical record documentation to identify diagnoses and procedures; Assign accurate ICD-10, CPT, and modifier codes; Complete coding, charging, and account abstraction within timelines; Identify missing documentation and communicate with providers to obtain required information; Monitor provider documentation and perform coding audits; Resolve missing charges and reimbursement-related issues; Provide education and feedback to providers on documentation issues.
Seniority
Mid-level, hands-on IC