Senior Medical Coding Specialist

Ember is seeking an experienced medical coding professional to join our team as a Senior Medical Coding Specialist. This role will focus on auditing and coding complex surgical notes. The ideal candidate will leverage their expertise to ensure accurate code assignment, compliance with regulations, and optimal reimbursement for our clients.

Essential Responsibilities

1. Analyze and audit complex surgical operative notes, particularly in cardiology and orthopedics, to ensure accurate code assignment and compliance.
2. Assign appropriate ICD-10, CPT, HCPCS codes and modifiers based on clinical documentation and payer requirements.
3. Serve as a key liaison between clinical teams and revenue cycle management, addressing coding inquiries and resolving complex coding issues.
4. Stay current with coding guidelines, payer policies, and regulatory changes affecting cardiology, orthopedics, and surgical specialties.
5. Identify and resolve coding edits and denials, implementing strategies to enhance revenue integrity.
6. Participate in quality improvement initiatives to optimize coding accuracy and efficiency.
7. Contribute to the development and maintenance of specialty-specific coding resources.

Required Qualifications

1. CPC or CCS certification required.
2. 3-5 years of experience in medical coding with emphasis on surgical procedures.
3. Demonstrated expertise in cardiology and orthopedic coding.
4. Proficiency in both inpatient and outpatient coding environments.
5. Advanced knowledge of anatomy, physiology, and medical terminology.

Preferred Qualifications

1. Additional specialty coding certifications (e.g., CCS-P, CCVTC).
2. Experience in auditing and identifying documentation improvement opportunities.
3. Background in revenue cycle management or denials management.
4. Experience with AI-assisted coding technologies.
5. Knowledge of compliance programs and regulatory requirements.

Competencies

1. Decision Making: Ability to make decisions guided by coding guidelines, policies, and objectives. Regularly makes recommendations on complex coding scenarios.
2. Problem Solving: Ability to address varied coding challenges requiring analysis and interpretation using direct observation, knowledge, and skills.
3. Communication: Excellent written and verbal communication skills to effectively interact with clinical providers and administrative staff.
4. Technical Knowledge: In-depth knowledge of coding concepts, practices, and policies with ability to apply them in complex clinical scenarios.
5. Attention to Detail: High level of accuracy and thoroughness in coding work.