Hospital Coding Specialist II - Remote

Overview

The Hospital Coding Specialist II at Riverside Healthcare is responsible for accurately coding and abstracting complex outpatient, observation, and ambulatory procedure medical records. This position ensures complete and compliant coding of assigned accounts to meet reimbursement, indexing, statistical, and reporting requirements and will demonstrates flexibility with assignments within professional scope/duties/licensure. The Specialist will also assist with end-of-month and error reconciliation processes, including retrospective verification of medical necessity. The ideal candidate must be able to work independently in a fast-paced environment, prioritize tasks effectively, and adapt to shifting needs. A mature, customer-focused attitude and professional demeanor are essential for success in this role.

In Short

• Accurately assign and sequence appropriate ICD-10-CM and CPT codes for all diagnoses, procedures, signs, symptoms, and conditions documented in medical records.
• Assign appropriate modifiers to CPT codes to fully describe the services rendered.
• Participate in the coding of complex outpatient, observation, and ambulatory procedure medical records.
• Assist with end-of-reporting-period tasks, backlog completion, medical necessity verification, and error reconciliation processes.
• Collaborate with Patient Financial Services and source departments to achieve accurate, timely coding and billing.
• Enter abstracted data into the Affinity system, ensuring that all information is accurate and complete.
• Classify cases into correct patient classification systems, such as APC (Ambulatory Payment Classifications) and EAPG (Enhanced Ambulatory Patient Groups).
• Link procedure codes assigned during the coding session to the correct operative episode, physician, and revenue code.
• Review and respond to APC, Outpatient Code Editor (OCE), Correct Coding Initiative (CCI), and medical necessity edits identified during the encoder session to achieve compliant coding and optimize reimbursement.
• Verify that all physicians involved in the patient’s care are correctly documented in the abstract.

Requirements

• Minimum of three (3) years of current ambulatory procedure coding experience in an acute care setting or a comprehensive ambulatory surgery center.
• Expertise in ICD-10-CM and CPT coding principles is essential.
• Thorough knowledge of Official Coding Guidelines.
• Strong background in medical terminology, human anatomy/physiology, pathophysiology, and disease processes.
• Proficient in Microsoft.
• Ability to read and write in English.
• Detail-oriented with a commitment to accuracy and strong problem-solving abilities.

Benefits

• Ability to work independently in a fast-paced environment and effectively manage multiple tasks.
• Expertise in applying official coding guidelines and assigning accurate codes for complex outpatient, observation, and ambulatory procedures.
• Excellent interpersonal and customer relations skills with a professional demeanor in all interactions.
• Proficiency in using computer systems for data entry and record-keeping.
• Ability to collaborate effectively with other departments, including Patient Financial Services, to ensure accurate coding and billing processes.
• Strong attention to detail with a commitment to accuracy in all aspects of coding and abstracting.