Accurately assign all codes (ICD-10-CM/PCS, CPT, HCPCS) for highly complex professional fee encounters (highest complexity level) or moderate to high complexity facility encounters
Serve as the authoritative internal expert for professional coding guidelines or a knowledgeable resource for facility guidelines.
Provide expert guidance, training, onboarding assistance, and mentorship to Coder I/II staff to enhance team performance and accuracy
Provide informal code review guidance as directed by leadership, focusing purely on the accuracy of code assignment and documentation translation for complex cases.
Review accounts placed on pre-bill hold to address specific coding edits, complex claim issues, and/or denial prevention strategies before final billing
Master and interpret complex regulatory updates and official coding guidelines (e.g., AHA Coding Clinic), translating changes into actionable processes for the team

Certification required: Academy of Coders (AAPC), OR American Health Information Management Association (AHIMA); Dual Certifications preferred
Associate’s Degree in Health Information Management or equivalent experience/advanced training beyond High School in Medical Coding required
Minimum of 5+ years of extensive medical coding experience, with significant experience in complex professional, inpatient, or outpatient facility coding.
Experience with Epic or similar electronic health record systems is required
Mastery of medical terminology, anatomy, physiology, and complex pathophysiology for multiple service lines/specialties/types
Expert knowledge of official coding guidelines, regulatory requirements, and comprehensive reimbursement models (DRG, RVU)
Exceptional analytical skills to manage the highest level of coding complexity in professional coding and moderate to high complexity in facility coding
Strong attention to detail and the ability to work independently to solve complex coding problems and interpret nuanced rules
Strong communication and interpersonal skills to effectively mentor staff and interact with support teams
Ability to meet deadlines while working in a fast-paced environment and take initiative in a collaborative environment

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short
and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Coder III – Plastics Specialty

Key skills