The Coding Specialist reviews superbills and corresponding medical record documentation and assigns appropriate CPT, HCPCS, modifier, and ICD-10 codes to post charges and help achieve maximum reimbursement in accordance with OSNI protocols and procedures, CMS guidelines, and private payer requirements.
Core responsibilities include daily charge posting, reviewing first-level rejected claims in practice management, using hospital portals to obtain operative reports and patient demographics, scanning completed work into SRS, querying physicians and ancillary medical staff when clarification is needed, ensuring records are amended when appropriate, and participating in internal provider coding review sessions.
Additional duties include accurate charge data entry, review and correction of electronic claim rejections, printing and mailing paper claims as needed, maintaining compliance with coding and legal requirements, supporting cross-training efforts, and assisting with special reports or other duties assigned by leadership.
Qualifications
- High school diploma or an equivalent combination of education and experience
- RHIT, CPC, or CCS required
- Associate degree or higher in coding, health information management, accounting, or business administration highly desired
- Data entry speed of 50–60 keystrokes per minute
- At least 1 year of experience in a healthcare setting, insurance company, managed care organization, or other financial services setting performing coding or billing functions
- Knowledge of insurance and governmental programs, regulations, billing processes, managed care contracts, and coordination of benefits
- Thorough working knowledge of medical terminology, anatomy and physiology, ICD-10, CPT, HCPCS, and basic computer skills
- Strong communication, organizational, interpersonal, attention-to-detail, accuracy, and time management skills
Physical Requirements
- Ability to work in an office setting and remain seated for periods of time
- Fine hand manipulation and keyboarding
- Ability to organize work priorities and adapt to changing demands
- Ability to manage multiple tasks in a potentially stressful environment
- Strong problem-solving skills
Location
Indiana, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
3 months ago