Medical Coding Specialist (remote)

Southwoods Health; Boardman (OH); Remote; USD 55,000 - 75,000; Full time

Job summary

Southwoods Health is seeking a detail-oriented Medical Coding Specialist to assign CPT/HCPCS and ICD-10-CM codes across patient encounters. You will review documentation to abstract E/M levels and ensure compliance with CMS guidelines.

Responsibilities include coordinating physician queries, applying payer-specific modifiers, and maintaining high accuracy and productivity while adhering to regulatory standards. Training is required for initial onboarding.

Qualifications

• Must hold one of the listed medical coding certifications (CCS, CCA, CPC, RHIT, COC, ACA, or CIC).
• One year in a healthcare setting; 10+ years of coding experience accepted in lieu of a certificate.
• Strong communication and computer skills are required.

Responsibilities

• Chart Abstraction: Review and abstract E/M levels from documentation.
• CPT Coding: Assign accurate CPT codes for surgeries, anesthesia, pain management, and radiology.
• Physician Queries: Coordinate provider queries within the Meditech system.
• Guidelines & Specificity: Apply CMS guidelines and HCPCS codes to ensure accuracy based on Place of Service.
• Payer Rules & Modifiers: Apply modifiers per payer rules (Medicaid/Medicare HMOs).
• Quality & Performance: Maintain at least 95% coding accuracy and productivity standards.
• Compliance Framework: Ensure processes meet regulatory requirements.
• Collaborative Support: Research coding inquiries and collaborate with supervisors.

Skills

Communication skills

Excel

Computer skills

Education

Medical coding certification (CCS, CCA, CPC, RHIT, COC, ACA, or CIC)

Tools

Meditech

Job description

Medical Coding Specialist

Southwoods Health | Boardman, OH

Status: Full-Time | Setting: Fully Remote or Fully In-Office

Note: Remote employees must live within a commutable distance from Boardman, OH for initial training.

About The Role

Southwoods Health is seeking a skilled and detail-oriented Medical Coding Specialist. In this role, you will be responsible for the proper assignment of all CPT/HCPCS and ICD-10-CM diagnosis codes to ensure compliant coding across all assigned patient encounters.

Essential Duties

• Chart Abstraction: Review and abstract evaluation and management (E/M) levels from specialty office or hospital documentation.
• CPT Coding: Assign accurate CPT codes for surgeries, anesthesia, pain management, and radiology services as required.
• Physician Queries: Coordinate physician queries within the Meditech system, or contact designated hospital representatives for non-Meditech provider locations.
• Guidelines & Specificity: Apply a strong understanding of bundling concepts, CMS guidelines, and HCPCS codes to ensure accurate assignment based on Place of Service (POS). Assign ICD-10 codes to the highest level of specificity.
• Payer Rules & Modifiers: Accurately append modifiers and adhere to distinct guidelines for specific payer groups, including Medicaid HMO and Medicare HMO networks.
• Quality & Performance: Maintain a minimum 95% coding accuracy rate while consistently meeting established productivity standards.
• Compliance Framework: Ensure all processes at assigned physician practices maintain strict compliance with all regulatory agencies.
• Collaborative Support: Research coding inquiries independently, collaborate with supervisors, and perform other duties as assigned.

Qualifications

• Current medical coding certification (CCS, CCA, CPC, RHIT, COC, ACA, or CIC)
• Responsible for the proper assignment of all CPT/HCPCS and ICD-10-CM diagnosis codes to ensure compliant coding of documentation provided for physician’s offices, specialty offices, hospitalist rounding, in office procedures, other as assigned
• At least one year in a healthcare setting, 10 or more years of coding experience will be accepted in lieu of a certificate
• Good Communication skills
• Working knowledge of Excel
• Good Computer Skills
• Strong ethical and moral character references

Why Southwoods?

At Southwoods, it's not just about the treatment, but how you're treated. Join an expanding, award-winning healthcare network that offers flexible work environments and values your specialized professional expertise. #SWH