OP Clinic Coding Specialist

📋 Description

• • Serve as an OP Clinic Coding Specialist providing accurate CPT, HCPCS, and ICD-10-CM coding for outpatient clinic visits across multiple specialties including Cardiology, Sleep Studies, Endocrinology, and GI.
• • Independently work from home while maintaining high standards of coding accuracy and productivity without direct on-site supervision.
• • Calculate ProFee and/or Facility E/M levels using the company’s proprietary algorithm to ensure proper reimbursement.
• • Identify and code critical care cases based on patient acuity to capture appropriate revenue.
• • Accurately code surgical procedures typical of an ER setting to maximize revenue capture when clinically justified.
• • Apply ICD-10-CM diagnosis codes to the highest level of specificity permitted by documentation.
• • Utilize ICD-10-CM, ICD-10-PCS, CPT®, and HCPCS coding systems to assign correct diagnosis and procedure codes.
• • Interpret official coding guidelines to ensure compliant and accurate code assignment.
• • Recognize the direct impact of clinical documentation quality on coding outcomes and subsequent reimbursement.
• • Adhere strictly to AHIMA’s Standards of Ethical Coding and CorroHealth’s Code of Ethics and Business Conduct.
• • Comply with all internal policies, procedures, and compliance programs including data privacy and security regulations.
• • Maintain ongoing proficiency in coding by actively participating in company-provided training and education programs.
• • Ensure continuous compliance with HIPAA and other privacy regulations regarding the protection of Protected Health Information (PHI).
• • Maintain a minimum productivity level and coding accuracy rate of 95% or higher.
• • Achieve and sustain a quality score of 95% or higher as measured by internal audits.
• • Proficiently use Microsoft Excel to open, edit, and perform basic calculations on spreadsheets (e.g., addition, multiplication).
• • Effectively use Microsoft Outlook to manage emails, schedule meetings, and attend virtual appointments.
• • Communicate clearly and professionally in both written and verbal formats with team members and leadership.
• • Coordinate tasks, analyze data, make informed coding decisions, and consistently meet deadlines.
• • Maintain current coding references including up-to-date CPT and ICD-10-CM codebooks.
• • Operate a reliable computer with high-speed internet and a phone to perform all job functions remotely.
• • Work up to 6–8 hours daily at a computer terminal with frequent interruptions and prolonged sitting.
• • May be required to lift and move materials weighing up to 20 lbs on rare occasions.
• • Perform additional duties as assigned by leadership to support operational needs.