Advanced Coding Specialist | Certified Health Information Coder

Join a dynamic healthcare team as an Advanced Coding Specialist, where your expertise in clinical documentation and coding will directly impact patient care and organizational success. This role involves reviewing clinical records and diagnostic results to accurately assign ICD-10 CM, ICD-10-PCS, and CPT/HCPCS codes for billing, reporting, research, and compliance purposes. You will handle coding responsibilities across various hospital departments including Ancillary, Emergency, Inpatient, Outpatient Surgery, Obstetrics, Infusion, and Long Term Care.

Key Responsibilities

• Adhere to ethical coding standards and official guidelines as outlined by the American Health Information Management Association (AHIMA).
• Apply ICD-10 CM and PCS codes to reflect patient visits accurately, identifying relevant MS-DRG and APR-DRG classifications that affect reimbursement.
• Collaborate effectively with physicians, clinical staff, and billing teams to ensure accurate coding and resolve queries.
• Utilize coding software and resources to manage inpatient coding, including procedures and diagnoses.
• Abstract essential data elements such as present on admission (POA) and discharge status as required.
• Communicate coding issues clearly to providers and Clinical Documentation Improvement Specialists to enhance documentation quality and revenue impact.
• Serve as a resource for coding questions and billing edit resolutions.
• Maintain a coding accuracy rate of 95% or higher and meet productivity standards.
• Comply with HIPAA regulations to protect patient information.

• Advanced knowledge of Anatomy and Physiology, Medical Terminology, Pharmacology, and ICD-10 CM/PCS coding.
• Proven ability to apply Complications and Co-Morbidity (CC) and Major Complication/Co-Morbidity (MCC) coding principles.
• Understanding of POA requirements, DRG, MS-DRG, and APR-DRG systems, including severity of illness and risk of mortality.
• Successful completion of courses in Anatomy and Physiology, Medical Terminology, and basic ICD-10-CM/PCS and CPT coding.
• Minimum of 2 years experience in Health Information Management, medical office, or healthcare environment.

• ICD-10 education and training.
• Three years of hospital inpatient coding experience.
• Certifications such as CCS, CCS-P, CPC, CPC-H, RHIT, or RHIA are highly desirable.

• Must obtain professional coding certification within one year of employment.

• Integrity: Demonstrate honesty and ethical behavior, inspiring others to uphold organizational values.
• Compassion: Show empathy and excellent customer service, managing conflicts and expectations with care.
• Accountability: Take ownership of projects and adapt flexibly to changing priorities.
• Respect: Collaborate effectively with diverse populations and maintain a positive service orientation.
• Excellence: Exhibit strong communication and leadership skills, capable of guiding teams and facilitating process improvements.