Medical Coding Specialist

Medical Coding Specialist – Job Description

Schedule: Monday–Friday, 8:00 AM–4:00 PM
Hours: 35 hours per week
Lunch: 30-minute unpaid lunch
Location: Primarily Cranston, RI, with occasional travel

Position Overview

We are seeking an experienced Medical Coding Specialist to review and evaluate inpatient and outpatient medical records, accurately assign diagnostic and procedural codes, and ensure proper billing and maximum financial reimbursement.

The individual will work with paper-based medical records, as the facility does not utilize an electronic medical records system. This position requires strong knowledge of ICD-10-CM and CPT-4 coding guidelines, medical terminology, and healthcare reimbursement regulations.

Job Responsibilities

• Review and evaluate inpatient and outpatient medical records to identify relevant diagnostic, procedural, and patient information.
• Assign accurate ICD-10-CM and CPT-4 codes in accordance with applicable coding guidelines and regulations.
• Ensure proper code selection and sequencing to maximize financial reimbursement.
• Identify incomplete or questionable documentation and communicate with physicians or medical records leadership for clarification.
• Collaborate with medical staff, medical records personnel, and billing departments regarding coding questions and concerns.
• Verify patient information and coding details on required abstract forms.
• Ensure completed records are accurately coded, abstracted, and forwarded to the billing department.
• Maintain weekly tracking logs of patient admissions, transfers, and discharges.
• Utilize computer systems to verify patient healthcare coverage.
• Maintain strict confidentiality of all patient and hospital information.
• Perform additional related duties as assigned.

Required Qualifications

• Medical Coding Certification is required.
• Must hold one of the following certifications:
• • CCS – Certified Coding Specialist through AHIMA
  • CPC – Certified Professional Coder through AAPC
• ICD-10 certification and demonstrated coding proficiency required.
• Experience working with inpatient and outpatient medical records.
• Experience with CPT-4 coding and healthcare reimbursement.
• Strong knowledge of medical terminology, anatomy, physiology, and pathology.
• Knowledge of Medicare, Medicaid, and third-party insurance billing regulations.
• Strong attention to detail and organizational skills.
• Ability to maintain confidentiality and handle sensitive medical information.

Additional Position Requirements

• Must have a valid driver's license.
• Must have reliable personal transportation.
• Occasional travel.
• Travel expenses and mileage will not be reimbursed.
• Must be comfortable working with paper medical records rather than an electronic medical records system.