About this role

Accurately assign CPT, ICD-10-CM, and HCPCS Level II codes for professional surgical services.
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.
Conduct claim review to support clean claim submission and reduce denials.
Audit coding accuracy through ad hoc reports, focused reviews, and special projects.
Collaborate with providers and operational leadership to clarify documentation and improve coding specificity.

High school diploma or equivalent.
Minimum five (5) years of professional medical coding experience.
Strong surgical coding experience required.
Active coding certification through AAPC (ie. CPC) or AHIMA (ie. CCS-P).
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.

Coding Specialist – Surgical Services

Key skills