About this role
Role Overview
- Review orders and supporting documentation to confirm accurate, compliant ICD-10 and CPT/HCPCS coding inputs needed for clean claim submission.
- Identify missing or incomplete claim-critical elements and drive timely remediation through established workflows.
- Confirm documentation and coding elements are in place prior to claim submission, escalating gaps for resolution as needed.
- Execute coding-focused quality checks and proactive audits to detect trends, prevent repeat errors, and reduce downstream denials tied to documentation or coding gaps.
- Partner with front-end operations to reduce missing billing information and rework before claims are submitted.
- Support visibility into pre-claim performance drivers by tracking and communicating recurring gap themes.
Requirements
- High school diploma or equivalent; additional education in health sciences or a related field preferred.
- Demonstrated working knowledge of ICD-10-CM and CPT/HCPCS coding concepts as applied to claim-submission readiness.
- Proven ability to identify missing or invalid claim-critical data elements and drive resolution through cross-functional coordination.
- Professional coding certification (AAPC/AHIMA or equivalent) preferred.
- Experience supporting pre-claim quality, audits, or denial prevention workflows in a high-volume healthcare revenue cycle environment.
Benefits
- Flexible work arrangements
- Professional development opportunities