Coding Specialist – Surgical Services

Role Overview

• 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
• Identify and address undercoding, overcoding, modifier misuse, and unbundling issues
• Apply appropriate modifiers and ensure correct provider, place of service, and payer selection
• 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

Requirements

• 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) (ie. CPC), or American Health Information Management Association (AHIMA) (ie. CCS-P)
• Certified Professional Medical Auditor (CPMA) through AAPC preferred
• Experience conducting internal coding audits
• Experience with CMS Part B and commercial payer reimbursement methodologies

Benefits

• Health insurance
• Retirement plans
• Paid time off
• Flexible work arrangements
• Professional development