Key Facts

Remote From:

Full time

Hard Skills

ICD 503 Cppunit Medical Guideline Revenue Management Industry Trend Analysis Microsoft Access Medical Coding Chargemaster Auditing Auditing Online Communication Engineering Optimization SharePoint Administration Presentation Training Process Improvement

Other Skills

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Microsoft Office
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Decision Making
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Non-Verbal Communication
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Analytical Skills
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Decisiveness

Job description

Overview:

The Coding Edit Specialist is responsible for completing coding edit work queues in EPIC in accordance with established coding guidelines and approved coding references. This role requires a strong understanding and practical use of ICD-10-CM, ICD-10-PCS, CPT, and medical necessity guidelines to ensure accurate and compliant coding practices.

The specialist applies excellent problem-solving skills to appropriately reconcile edits and provide clear, constructive feedback to coders based on audit findings. Additionally, the position is responsible for composing summaries of audit results to assist in trending, reporting, and data analysis that support ongoing process improvement within the department.

Qualifications:

Required Education and Experience

Required Education:
- High School Diploma or GED
Preferred Education:
- Associate’s or Bachelor’s Degree

Licensure / Certifications

Required:
- Must hold one (1) of the following certifications:
  - Registered Health Information Administrator (RHIA)
  - Registered Health Information Technician (RHIT)
  - Certified Coding Specialist (CCS)
  - Certified Coding Specialist–Physician-based (CCS-P)
  - Certified Professional Coder (CPC)
Preferred:
- None

Experience

Required:
- Three (3) to five (5) years of acute care coding experience
Preferred:
- Three (3) to five (5) years of experience coding across both inpatient and outpatient patient types

Necessary Skills and Abilities

Ability to problem-solve complex coding edits, including those related to billing issues, utilizing strong coding compliance knowledge.
Proficient in ICD-10-CM, ICD-10-PCS, and CPT coding systems.
Knowledgeable in medical necessity requirements.
Demonstrates a global understanding of the revenue cycle and the chargemaster process.
Exhibits accuracy, thoroughness, and sound judgment in decision-making.
Excels in analyzing and optimizing work procedures to achieve maximum efficiency.
Proficient in the use of technology tools for administrative support and efficiency, including Microsoft Access and the Microsoft Office Suite.
Possesses excellent oral and written communication skills with the ability to present information clearly and effectively.