Certified Coding Specialist

Mountains-Community-Hospital; Lake Arrowhead (CA); Hybrid; USD 90,000 - 130,000; Full time

Benefits offered by this job

Hybrid work option

Job summary

Mountains Community Hospital seeks a detail-oriented Certified Coding Specialist to ensure accurate medical coding, charge capture, and regulatory compliance across hospital and outpatient services.

The role involves reviewing records, assigning ICD-10-CM/PCS, CPT, and HCPCS codes, reconciling charges, and supporting coding audits. Collaboration with HIM, clinical staff, and billing is essential to maintain data integrity and compliant reimbursement.

Qualifications

• Active coding credential from AHIMA or AAPC.
• Ability to interpret medical documentation and apply coding guidelines across settings.
• 3+ years of medical coding experience.
• Experience in Rural Health/Critical Access Hospital preferred.
• Experience with inpatient and various outpatient coding scenarios.

Responsibilities

• Review medical records for accuracy and coding requirements.
• Assign ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes per guidelines.
• Code inpatient, swing bed, ED, observation, same day surgery and outpatient encounters.
• Review and reconcile charges to support accurate billing.
• Identify documentation deficiencies and coordinate provider queries.
• Support coding audits, record reviews, and corrective actions.
• Maintain HIPAA compliance and protect patient information.
• Collaborate with HIM, clinical staff, and billing to resolve discrepancies.

Skills

ICD-10-CM/ICD-10-PCS knowledge

CPT/HCPCS coding

Documentation review

Attention to detail

Regulatory compliance

Education

CCS (AHIMA)

CCS-P (AHIMA)

RHIT (AHIMA)

RHIA (AHIMA)

CPC (AAPC)

Tools

EHR proficiency

Coding software

Job description

Position Summary

Mountains Community Hospital is seeking a detail-oriented and knowledgeable Certified Coding Specialist to support accurate medical coding, charge capture, documentation review, and regulatory compliance across multiple hospital and outpatient service areas.

The Certified Coding Specialist is responsible for reviewing medical records, assigning appropriate diagnosis and procedure codes, reconciling charges, supporting coding audits, and promoting compliance with applicable coding guidelines and reimbursement requirements. This position works collaboratively with Health Information Management, clinical staff, providers, and other departments to ensure the accuracy, completeness, and integrity of coded health records.

Essential Duties and Responsibilities

• Review medical records for documentation accuracy, completeness, and coding requirements.
• Assign appropriate ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes in accordance with established coding guidelines.
• Code inpatient, swing bed, Emergency Department, observation, same day surgery, endoscopy, Rural Health Clinic, and other outpatient encounters.
• Review and reconcile charges to support accurate billing and reimbursement.
• Identify documentation deficiencies and coordinate appropriate provider queries in accordance with established policies and compliance standards.
• Support internal and external coding audits, record reviews, and corrective action activities.
• Monitor compliance with applicable coding guidelines, regulatory requirements, and reimbursement standards.
• Collaborate with clinical, billing, and Health Information Management staff to resolve coding and documentation discrepancies.
• Participate in quality improvement initiatives and coding education as needed.
• Maintain the confidentiality and security of patient health information in accordance with HIPAA and hospital policies.
• Maintain required professional credentials and participate in continuing education to remain current with coding standards and industry changes.
• Perform other related duties as assigned.

Minimum Qualifications

• High school diploma or equivalent required.
• Current, active coding or health information management credential from AHIMA or AAPC, as specified below.
• Ability to interpret medical documentation and apply appropriate coding guidelines across multiple healthcare settings.

Required Certification

Candidates must possess and maintain at least one current, active credential from the following list:

AHIMA

• Certified Coding Specialist (CCS)
• Certified Coding Specialist–Physician-Based (CCS-P)
• Registered Health Information Technician (RHIT)
• Registered Health Information Administrator (RHIA)

AAPC

• Certified Professional Coder (CPC)
• Certified Outpatient Coder (COC)
• Certified Inpatient Coder (CIC)

Certification must remain active throughout employment.

Preferred Qualifications

• CCS, RHIT, RHIA, or CIC certification.
• Three or more years of medical coding experience.
• Experience coding in a Critical Access Hospital or rural healthcare setting.
• Experience with inpatient, swing bed, Emergency Department, observation, same day surgery, endoscopy, Rural Health Clinic, and outpatient services.
• Familiarity with healthcare billing, charge reconciliation, coding audits, documentation improvement, and regulatory compliance.

Knowledge, Skills, and Abilities

• Comprehensive knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, and official coding guidelines.
• Knowledge of anatomy, physiology, pharmacology, medical terminology, and healthcare documentation requirements.
• Ability to analyze medical records and apply coding guidelines accurately and consistently.
• Strong attention to detail, organization, and time management.
• Ability to meet established productivity and quality standards while maintaining coding accuracy and compliance.
• Effective written and verbal communication skills and the ability to work collaboratively with providers and interdisciplinary teams.
• Ability to maintain confidentiality and exercise sound professional judgment.
• Proficiency with electronic health records, coding software, and related computer applications.

Work Schedule and Hybrid Opportunity

This is a full-time position working 40 hours per week, with flexible scheduling options based on departmental needs.

Hybrid work may be available after successful completion of the probationary period. Eligibility will be determined based on demonstrated productivity, coding accuracy, quality, compliance, and operational requirements. Hybrid arrangements are subject to hospital approval and may be modified based on business needs.

Why Join Mountains Community Hospital?

Join a team committed to providing quality healthcare to our rural community. At MCH, your expertise helps support accurate reimbursement, regulatory compliance, high-quality documentation, and the delivery of exceptional patient care.

Mountains Community Hospital is an equal opportunity employer.