Coding Advocate

CPSI; United States; Remote; USD 52,000 - 70,000; Full time

Job summary

CPSI is seeking a Coding Advocate to handle medical coding and data entry/abstraction across Hospital Inpatient, Outpatient, Ambulatory, Surgery, Emergency and Special Procedures. The role ensures accurate coding and compliance with HIPAA and related regulations.

You will float between sites, apply ICD-10-CM/PCS, CPT and modifiers, review claims for medical necessity, and support client service with precise documentation and collaboration with teammates.

Qualifications

• 2 year degree or equivalent with AHIMA or AAPC certification.
• Active credentials RHIA, RHIT, CCS, CPC, or COC.
• Minimum 1 year of medical coding experience.
• Excellent communication and organizational skills.
• Ability to work independently and as a team member.

Responsibilities

• Inpatient: assign ICD-10-CM and PCS codes and accurately determine DRG.
• Outpatient: assign modifiers and CPT codes for outpatient coding.
• Outpatient Surgery: assign CPT codes for outpatient procedures per contract.
• Emergency Room: assign diagnosis codes and E/M levels and related CPT codes.
• Create compliant physician queries as needed.
• Review claims for medical necessity and update problem lists.
• Assign present on admission indicators.
• Support clients with excellent service and collaborate with teammates.
• Float between multiple sites and coding specialties as required.

Skills

Communication

Time management

Multi-tasking

Detail oriented

Team player

Independent

Education

2 year degree or equivalent

AHIMA or AAPC certification

RHIA / RHIT / CCS / CPC / COC credentials

Job description

The Coding Advocate will handle medical coding and data entry / abstraction for various types of Hospital visits: Inpatient, Outpatient, Ambulatory, Surgery, Emergency and Special Procedures.

These Goals and objectives are not to be construed as a complete statement of all duties performed; employees will be required to perform other job related duties as required. Goals and objectives are subject to change.

All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA and other regulations, as appropriate.

Essential Functions:

• Inpatient: Accurately assigns ICD-10-CM and PCS primary and secondary diagnoses and procedure codes based on the documentation in the record and in accordance with the site specific guidelines and policies. Accurate assignment of the DRG.
• Outpatient: Correctly assigns modifiers to chargemaster items and coder assigned CPT codes as applicable to outpatient coding, as appropriate.
• Outpatient Surgery: Correctly assigns CPT codes to outpatient procedures consistent with client contract and documentation in the record.
• Emergency Room: Correctly assign diagnosis codes, assign appropriate E&M facility and/or profee levels, assign infusion and injection CPT codes.
• Ability to create compliant physician queries.
• Accurately review claims for medical necessity.
• Update problem lists consistent with client contract.
• Correctly assign present on admission indicators.
• Ability to provide excellent customer service to our clients and teammates.
• Consistently demonstrates an excellent attitude, and works to strengthen the team as a whole.
• Floats between multiple sites, and coding specialties with ease and flexibility.

Minimum Requirements:

Education/Experience/Certification Requirements

• 2 year degree or equivalent experience; AHIMA or AAPC certification required
• Actively holds one or more of the following credentials: RHIA, RHIT, CCS, CPC, COC
• Minimum of 1 year experience coding
• Meets or exceeds Quality and Productivity standards.
• Excellent communication (written and oral) and interpersonal skills.
• Strong organizational, multi-tasking, and time-management skills.
• Must be detail oriented and able to follow through on issues to resolution.
• Must be able to act both independently, and as a team member.
• Excellent communication (written and oral) and interpersonal skills.
• Strong organizational, multi-tasking, and time-management skills.
• Must be detail oriented and able to follow through on issues to resolution.
• Must be able to act both independently and as a team member.

Preferred Qualifications:

• 2+ years of coding experience in multiple patient types
• Experience coding and charging injections and infusions
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