Advanced Coding Specialist

OSS Health; Pennsylvania; On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive wages

Medical, Dental, Vision

Disability & Life Insurance

Paid Time Off

401(k) plan and profit sharing

Career advancement opportunities

Job summary

OSS Health's Advanced Coding Specialist works within the Revenue Cycle Management Coding Department to assign ICD-10-CM, ICD-10-PCS, CPT and HCPCS codes for hospital, ASC and on-site services, including ED consults and hospitalist coverage.

This role requires reviewing operative reports and documentation, ensuring coding compliance with regulations and payer policies, and staying current with coding updates and guidelines. Schedule is Monday through Friday, 8:00 a.m. to 4:30 p.m.

Qualifications

• 1 year hands-on surgical coding experience.
• Fluent written and spoken English.
• Active professional certification CPC or CCS.

Responsibilities

• Extract codes from operative reports and records using CPT/HCPCS and ICD-10-CM/PCS.
• Ensure coding compliance with HIPAA, payer policies, and regulations.
• Identify and resolve documentation deficiencies by communicating with providers.
• Stay current on coding updates and payer guidelines.
• Support overall revenue cycle efficiency and productivity goals.

Skills

Surgical coding

English proficiency

Education

High school diploma or equivalent

AAPC CPC or AHIMA CCS

Advanced specialty certification (COC/CIC/COSC/CANPC)

Tools

Coding software

Encoder

Job description

At OSS Health, our mission is to continually strive to be the healthcare leader in quality, innovation and value. We make every effort to understand and exceed the expectations and needs of our patients. We are committed to providing an environment that is safe, respectful, and dignified at all times.

Joining OSS Health means joining a culture of excellence and teamwork, with a strong focus on employee development and community support. OSS Health offers a great work environment, professional development opportunities, meaningful careers, and competitive compensation.

JOB SUMMARY:

The Advanced Coding Specialist operates as a member of the Coding Department within Revenue Cycle Management. The Advanced Coding Specialist is responsible for coding physician and facility services for the hospital, ASC, ED consults, hospitalist services and/or on-call, offsite services.

SCHEDULE:

Monday-Friday - 8am-4:30pm

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Examine operative reports, anesthesia records, and surgical findings to extract accurate ICD-10 CM, ICD-10-PCS, CPT, and HCPCS codes based on payer, provider, and/or location billing requirements.
• Ensures coding compliance with federal regulations, payer policies, HIPAA and industry standards.
• Identify and resolve documentation deficiencies; communicate with providers when clarification is needed
• Validates surgical requirements are met within clinical and financial records
• Utilizes coding software, encoder and other resources provided
• Stay current on coding updates, payer guidelines, and healthcare regulations.
• Support overall revenue cycle efficiency
• Maintains productivity goals set by department
• Assists with E/M coding as needed
• Other duties as assigned.

EDUCATION:

• High school diploma or equivalent required

EXPERIENCE/QUALIFICATIONS:

• High school diploma or equivalent required
• Active AAPC, CPC or AHIMA CCS certification
• Active advanced specialty certification though AAPC or AHIMA (e.g. COC, CIC, COSC, CASCC, CANPC, CDEO, CDEI, CGSC, CIRCC)
• Minimum of 1-year hands-on surgical coding experience and facility-based billing
• Strong understanding of CPT, HCPCS Level II procedure and supply codes, Anesthesia coding, and ICD-10-CM diagnosis coding.
• Knowledge of coding in surgical practices, ambulatory surgery centers, and inpatient and outpatient hospital settings.
• Strong understanding of National Correct Coding Initiative (NCCI) edits, medical necessity requirements and bundling guidelines.
• Advanced analytical and problem-solving skills.
• Ability to work independently
• High-level knowledge of general surgery-related medical terminology, anatomy, and pathophysiology.
• Fluent written and spoken English required.

BENEFITS INCLUDE:

• Competitive Wages
• Medical, Dental, Vision available on the first day of employment
• Disability, and Life Insurance within 90 days
• Company-Paid Group Life Insurance, Short-Term Disability & Long-Term Disability
• Paid Time Off (PTO)
• 401(k) plan and profit sharing
• Career Advancement Opportunities