Coding Specialist Surgical Services Hybrid
Dallas, IA - USA
Job Summary
Integrative Emergency Services LLC (IES) is seeking aCoding Specialist with emphasis on surgical services.The Coding Specialist is responsible for accurate professional fee coding and documentation review for assigned surgical service lines (URSA/NTCC/TSN). This role evaluates medical records to ensure proper CPT HCPCS Level II and ICD-10-CM code assignment in accordance with payer guidelines and regulatory standards. The Coding Specialist supports documentation integrity identifies coding compliance risks (including undercoding overcoding and unbundling) and contributes to clean claim submission and optimal reimbursement through coding analysis audits and special projects Work will be based in a Hybrid format at the corporate office in North Dallas TX 75244.
IES is dedicated to cultivating best practices in emergency care providing comprehensive acute care services creating value and supporting patients employees clients providers and physicians in pursuit of the highest quality health care.
ESSENTIAL DUTIES AND RESPONSIBILITIESThe responsibilities listed here represent the majority of the role but are not all-inclusive; other duties may be assigned.
- 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.
- Maintain productivity and quality benchmarks established by the department.
- Serve as a subject matter resource for surgical coding guidance within assigned service lines.
QUALIFICATIONS
Knowledge Skills Abilities:To perform this job successfully an individual must be able to perform each essential duty satisfactorily.
- High-level knowledge of general surgery-related medical terminology anatomy and pathophysiology.
- Strong understanding of CPT procedure coding HCPCS Level II procedure and supply codes and ICD-10-CM diagnosis coding.
- Knowledge of coding in surgical practices ambulatory surgery centers and hospital settings.
- Ability to evaluate documentation for medical necessity and coding compliance.
- Strong understanding of National Correct Coding Initiative (NCCI) edits and bundling guidelines.
- Ability to audit reports conduct focused reviews and participate in special projects.
- Advanced analytical and problem-solving skills.
- High attention to detail and accuracy.
- Proficiency with EHR systems practice management systems and claim scrubber tools.
- Strong written and verbal communication skills.
- Ability to manage multiple priorities and meet deadlines.
- Proficiency in Microsoft Office applications.
- Ability to maintain confidentiality and exercise professional discretion.
Education / Experience: Include minimum education technical training and/or experience preferred to perform the job.
Required:
- 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) (-P).
Preferred:
- Certified Professional Medical Auditor (CPMA) through AAPC.
- Experience conducting internal coding audits.
- Experience with CMS Part B and commercial payer reimbursement methodologies.
PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
- Specific vision requirements include the ability to see at close range distance vision peripheral vision depth perception and the ability to adjust focus
- While performing the duties of this job the employee is regularly required to talk and hear
- Frequently required to stand walk sit use hands to feel and reach with hands and arms.
- Possess the ability to fulfill any office activities normally expected in an office setting to include but not limited to remaining seated for periods of time to perform computer-based work participating in filing activity lifting and carrying office supplies (paper reams mail etc.)
- Occasionally lift and/or move up to 20-25 pounds
- Fine hand manipulation (keyboarding)
WORK ENVIRONMENT:The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job
- Office environment Hybrid schedule after initial training period
- 4835 Lyndon B Johnson Fwy Dallas TX 75244
- Monday/Friday remote
- Tuesday-Thursday in office 8am-5pm
- The noise level in the work environment is usually low
TRAVEL:
- Some travel including overnight and local may be required as business needs dictate.
ADA & Reasonable Accommodation Statement:
IES is committed to providing equal employment opportunities to qualified individuals with accordance with the Americans with Disabilities Act (ADA) reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job. If you require accommodation during the application or employment process please contact emailprotected.
The company is committed to creating a diverse inclusive and equitable environment and is proud to be an equal opportunity employer. Qualified applicants of any age race religion nationality sexual orientation gender identity or expression disability or veteran status will receive equal consideration for positions. We welcome people of diverse backgrounds experiences and abilities and believe that the unique experiences of our team drive our success.
Required Experience:
Senior IC
About Company
Thank you for visiting our Job Board! At IES, we are leaders, innovators and champions for change, and our expertise allows us to achieve the best possible outcomes for the hospitals, practice and patients we serve. We are comprised of a solid, dedicated team that has practiced togeth ... View more