Medical Coding Specialist

Company Description

Our history as a document data processing / AI acceleration company dates back to the days when microform scanning and conversion was the big deal. BIS is best known for Grooper software, which was launched in 2016, but we actually got our start in 1986.

Over the years, our clients have created powerful business outcomes across all industries, such as:

• Financial services
• Local, state, and federal government
• Energy
• Insurance
• Technology providers
• Higher education
• And many others

Our clients have had success in various horizontal applications such as accounting automation, HR automation, loan processing, customer onboarding, and others. 

We’re a decades old trusted technology provider and the creator of Grooper, the first intelligent document processing software and AI acceleration solution.

We weren’t always a software development company, but the lack of innovation in document-based data capture drove us to create something new.

Role Description

The Medical Coding Specialist plays a vital role in the healthcare revenue cycle by ensuring that all patient diagnoses, procedures, and services are accurately translated into standardized medical codes. This position requires a deep understanding of ICD-10, CPT, and HCPCS coding systems, as well as familiarity with medical terminology, payer guidelines, and healthcare regulations.

The ideal candidate will possess strong analytical skills, excellent attention to detail, and the ability to interpret complex medical records. The Coding Specialist works closely with physicians, clinical staff, and billing teams to ensure accurate documentation, proper reimbursement, and full compliance with regulatory and payer requirements.

Essential Duties and Responsibilities

• Assign Accurate Codes:
• Translate diagnoses, procedures, and treatments from medical documentation into standardized ICD-10, CPT, and HCPCS codes in accordance with national and payer-specific coding guidelines.
• Review and Analyze Medical Records:
• Examine clinical documentation, physician notes, lab results, and operative reports to ensure completeness and accuracy before coding. Identify any discrepancies or missing information and follow up for clarification.
• Prepare and Submit Claims:
• Compile coded data and prepare accurate claims for submission to insurance companies, ensuring all necessary documentation and supporting details are included for prompt reimbursement.
• Ensure Data Integrity and Compliance:
• Maintain compliance with federal and state regulations, payer rules, and internal policies. Monitor coding accuracy to reduce denials, prevent compliance risks, and promote proper reimbursement.
• Maintain Patient Confidentiality:
• Uphold all standards of patient privacy and security as required by HIPAA and organizational policies, handling all health information with the highest level of discretion.
• Collaborate with Healthcare Providers:
• Communicate with physicians, nurses, and other healthcare professionals to clarify ambiguous or incomplete documentation, ensuring accurate code assignment and complete patient records.
• Monitor Coding and Billing Trends:
• Identify recurring coding or documentation issues, report trends to management, and assist in developing solutions or training opportunities to improve workflow and accuracy.
• Participate in Audits and Quality Reviews:
• Support both internal and external audits by providing documentation, explanations, and corrections as requested. Participate in regular quality assurance reviews to maintain high coding accuracy rates.
• Stay Current with Industry Changes:
• Remain informed of changes to coding guidelines, payer requirements, and healthcare regulations through ongoing education, workshops, and professional certification renewals.
• Support Revenue Cycle Operations:
• Work collaboratively with billing, reimbursement, and compliance teams to resolve claim rejections or denials related to coding discrepancies, contributing to optimal revenue capture.

Qualifications

• Education:
• High school diploma or equivalent required.
• Associate degree or certificate in Health Information Management, Medical Coding, or related field preferred.

• Certification:
• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent professional coding credential preferred.
• Additional specialty certifications (e.g., COC, CIC, or CRC) a plus.

• Experience:
• Minimum of 3-5 years of experience in medical coding within a hospital, clinic, or physician office setting preferred.
• Experience with electronic health records (EHR), practice management systems, and coding/billing software highly desirable.

• Knowledge and Skills:
• Strong understanding of ICD-10-CM, CPT, and HCPCS Level II coding systems.
• Working knowledge of anatomy, physiology, medical terminology, and clinical documentation requirements.
• Familiarity with payer reimbursement policies, claims submission procedures, and denial management.
• Excellent attention to detail, organizational, and analytical skills.
• Ability to communicate effectively with healthcare professionals and administrative staff.
• Proficiency with Microsoft Office Suite and coding platforms such as 3M, Epic, or Cerner.

https://www.paycomonline.net/v4/ats/web.php/jobs/ViewJobDetails?job=228416&clientkey=13C1D919918BA0E4EA174E4E7CCA2006