Medical Coding Specialist - Surgical Services

Integrative Emergency Services; South Carolina; Hybrid; USD 65.000 - 90.000; Vollzeit

Zusammenfassung

Integrative Emergency Services, LLC (IES) seeks a Medical Coding Specialist focused on surgical services. The role involves coding professional fees using CPT, ICD-10-CM, and HCPCS Level II, reviewing documentation, and ensuring compliance with CMS and payer guidelines.

Strong surgical coding experience and an active AAPC or AHIMA certification are required. Candidates may work in hybrid or remote settings; remote candidates must reside in IES-operated states (AZ, CO, TX, OK, IN, MO, AL, SC,

Qualifikationen

• Minimum five (5) years of professional medical coding experience.
• Strong surgical coding experience required.
• Active coding certification through: AAPC or AHIMA
• Surgical related Coding Certification (CGSC, CASCC, CCVTC, etc) or Auditing(CPMA) preferred.
• Experience with CMS Part B and commercial payer reimbursement methodologies.
• Proficiency with EHR systems, practice management systems, and claim scrubber tools.
• Proficiency in Microsoft Office applications.

Aufgaben

• Accurately assign CPT, ICD-10-CM, and HCPCS Level II codes for professional surgical services based on thorough medical record review.
• Evaluate medical records for proper code assignment, completeness, accuracy, and support of medical necessity.
• Ensure coding compliance with CMS, commercial payer, and regulatory guidelines.
• Conduct claim review to support clean claim submission and reduce denials.
• Audit coding accuracy through ad hoc reports, focused reviews, and special projects.
• Analyze coding-related denials and recommend corrective actions.
• Review payer policies and stay current on annual coding updates and regulatory changes.
• Collaborate with providers and operational leadership to clarify documentation and improve coding specificity.
• Maintain productivity and quality benchmarks established by the department.
• Serve as a subject matter resource for surgical coding guidance within assigned service lines
• High-level knowledge of general surgery-related medical terminology, anatomy, and pathophysiology.
• Strong understanding of CPT procedure coding, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis coding.
• Knowledge of coding in surgical practices, ambulatory surgery centers, and hospital settings.
• Ability to evaluate documentation for medical necessity and coding compliance.
• Strong understanding of National Correct Coding Initiative (NCCI) edits and bundling guidelines.
• Ability to audit reports, conduct focused reviews, and participate in special projects.

Kenntnisse

CPT coding

ICD-10-CM

HCPCS Level II

NCCI edits

EHR systems

MS Office

Surgical coding

Audit coding

Documentation review

CMS guidelines

Ausbildung

High school diploma or equivalent

AAPC or AHIMA certification

Tools

Practice management systems

Claim scrubber tools

Jobbeschreibung

Integrative Emergency Services (“IES”) LLC, is a physician founded, owned, and led company whose goal is to empower physician leaders to create the best places to give and receive care. We are a clinically integrated and outcomes-based organization with a commitment to doing the right thing for our clinicians, patients, and communities. Through our commitment to patient care and reinvestment in our physicians, IES has a proven track record of improving patient outcomes and producing results that uphold the hospitals' reputations in which we operate. We strive to create a culture of continuous improvement, community, and recognizing our Physician leaders. To learn more, visit our website IES.Healthcare and click to see a highlight of our 12th Annual Quality Summit.

Integrative Emergency Services, LLC (“IES”) is seeking a certified Medical Coding Specialist with emphasis on surgical services.

The Medical Coding Specialist responsible for accurate professional fee coding and documentation review for assigned surgical service lines ( URSA / NTCC / TSN ). This role evaluates medical records to ensure proper CPT, HCPCS Level II, and ICD-10-CM code assignment in accordance with payer guidelines and regulatory standards. The Coding Specialist supports documentation integrity, identifies coding compliance risks (including undercoding, overcoding, and unbundling), and contributes to clean claim submission and optimal reimbursement through coding analysis, audits, and special projects.

Candidates can work in either a hybrid or remote setting. If remote, must reside in a state IES operates in: AZ, CO, TX, OK, IN, MO, AL, SC, FL. Must have a coding certification via AAPC or AHIMA.

• Accurately assign CPT, ICD-10-CM, and HCPCS Level II codes for professional surgical services based on thorough medical record review.
• Evaluate medical records for proper code assignment, completeness, accuracy, and support of medical necessity.
• Ensure coding compliance with CMS, commercial payer, and regulatory guidelines.
• Conduct claim review to support clean claim submission and reduce denials.
• Audit coding accuracy through ad hoc reports, focused reviews, and special projects.
• Analyze coding-related denials and recommend corrective actions.
• Review payer policies and stay current on annual coding updates and regulatory changes.
• Collaborate with providers and operational leadership to clarify documentation and improve coding specificity.
• Maintain productivity and quality benchmarks established by the department.
• Serve as a subject matter resource for surgical coding guidance within assigned service lines
• High-level knowledge of general surgery-related medical terminology, anatomy, and pathophysiology.
• Strong understanding of CPT procedure coding, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis coding.
• Knowledge of coding in surgical practices, ambulatory surgery centers, and hospital settings.
• Ability to evaluate documentation for medical necessity and coding compliance.
• Strong understanding of National Correct Coding Initiative (NCCI) edits and bundling guidelines.
• Ability to audit reports, conduct focused reviews, and participate in special projects.
• Proficiency with EHR systems, practice management systems, and claim scrubber tools.
• Proficiency in Microsoft Office applications.

Education / Experience: Includes minimum education, technical training, and/or experience preferred to perform the job.

• High school diploma or equivalent.
• Minimum five (5) years of professional medical coding experience.
• Strong surgical coding experience required.
• Active coding certification through: American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA)
• Surgical related Coding Certification (CGSC, CASCC, CCVTC, etc) or Auditing(CPMA)
• Experience conducting internal coding audits.
• Experience with CMS Part B and commercial payer reimbursement methodologies
• Possess the ability to fulfill any office activities normally expected in an office setting, to include, but not limited to remaining seated for periods of time to perform computer-based work, participating in filing activity, lifting and carrying office supplies (paper reams, mail, etc.)
• Hybrid office environment orflexible for remote
• Corporate office: If remote, mustreside in a state IES operates in

TRAVEL:

• ~ Some travel, including overnight and local, may be required as business needs dictate.

IES is committed to providing equal employment opportunities to qualified individuals with disabilities. In accordance with the Americans with Disabilities Act (ADA), reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job. If you require accommodation during the application or employment process, please contact .

Qualified applicants of any age, race, religion, nationality, sexual orientation, gender identity or expression, disability, or veteran status will receive equal consideration for positions.