Medical Coding Specialist

We are seeking a detail-oriented Medical Coder to ensure the accurate assignment of ICD-10-CM, CPT, and HCPCS codes by thoroughly reviewing complete medical records. The ideal candidate will apply appropriate modifiers, maintain strict regulatory compliance, and protect patient health information in accordance with HIPAA standards. Staying current with coding updates from AMA, CMS, and payer policies is essential to support clean billing and minimize audit risks.

Key Responsibilities:
- Review medical documentation through chart audits to verify billing accuracy and provide feedback to healthcare providers on any discrepancies.
- Collaborate with providers to clarify incomplete or ambiguous documentation, ensuring precise coding.
- Assist the billing team in resolving denied claims by identifying and correcting coding-related issues for timely resubmission.
- Accurately code multi-service encounters, including preventive care, procedures, behavioral health, and chronic care management.
- Apply payer-specific coding rules, adhering to Medicare, Medicaid, and managed care plan policies to ensure compliance and reimbursement accuracy.
- Perform duties both remotely and onsite according to clinic policies, with flexibility for in-person meetings and training sessions.
- Serve as a backup supervisor by managing team workflow, addressing staff concerns, and participating in interview processes when authorized.
- Support business development efforts by providing accurate coding insights for internal inquiries and clinic outreach initiatives.
- Manage incoming patient and coding-related queries submitted through the clinic’s website, ensuring timely and accurate responses.
- Train and guide offshore coding teams to maintain consistency and uphold coding standards across locations.
- Provide operational solutions by resolving complex coding challenges and ensuring compliance during cross-departmental collaborations.
- Act as a liaison for clinic operations and coding-related queries within the Riceland network, facilitating smooth communication and workflow.

Required Qualifications:
- Proven experience in medical coding with a strong understanding of ICD-10-CM, CPT, and HCPCS coding systems.
- Familiarity with applying modifiers and payer-specific coding rules, including Medicare, Medicaid, and managed care plans.
- Knowledge of CMS guidelines and compliance requirements to reduce audit risks and support clean billing practices.
- Commitment to protecting patient health information in accordance with HIPAA regulations.
- Ability to conduct thorough chart audits and communicate effectively with healthcare providers to resolve documentation issues.
- Experience in handling denied claims and collaborating with billing teams to ensure accurate resubmission.
- Strong organizational skills with the ability to manage multiple responsibilities, including training offshore teams and acting as supervisor backup.
- Flexibility to work both remotely and onsite as required by clinic policy.

Preferred Qualifications and Benefits:
- Experience in coding a variety of clinical services, including behavioral health and chronic care management, is highly desirable.
- Previous supervisory or team lead experience is an advantage.
- Opportunity to contribute to business development and operational improvements within the clinic network.
- Full-time position with in-person work location, offering a collaborative environment and opportunities for professional growth.

This role is ideal for a motivated medical coding professional seeking to apply their expertise in a dynamic clinical setting while supporting operational excellence and compliance.