Professional, Coding (2/11)

Position Summary

We are seeking an experienced E/M coder with strong Outpatient (OP) and Inpatient (IP) coding knowledge to support coding quality, denial prevention, and rejection resolution activities. The individual will serve as a subject matter expert (SME), assisting coders in accurate code assignment, denial analysis, and provider documentation improvement.

Key Responsibilities

• •Review and resolve coding-related denials and rejections.
• •Perform OP and IP E/M coding audits, Surgery knowledge would be an added advantage.
• •Validate E/M level selection based on MDM and time-based guidelines.
• •Identify root causes and denial trends.
• •Provide coding education and feedback to team members.
• •Support quality initiatives and coding accuracy improvements.
• •Collaborate with Operations, Quality, and Denial Management teams.
• •Assist with provider documentation clarification when needed.

Required Qualifications

• •Minimum 3-5 years of E/M coding experience.
• •Strong knowledge of OP and IP E/M guidelines.
• •Experience reviewing coding denials and payer rejections.
• •Ability to interpret medical records and apply coding guidelines accurately.
• •Strong analytical and communication skills.
• •CPC, CCS, or equivalent coding certification preferred.

Preferred Skills

• •Strong understanding of medical necessity requirements.
• •Knowledge of modifier usage and payer-specific guidelines.
• •Ability to mentor and support junior coders.
• •Experience in eCW, Athena, Epic & Cerner

Key Competencies

• •Attention to Detail
• •Critical Thinking
• •Problem Solving
• •Quality Focus
• •Effective Communication
• •Team Collaboration