Coding Auditor
Aya Healthcare
Coding Specialist - Hospital Based, Emergency Department
Southern New Hampshire Health has been a cornerstone of the region since 1893, delivering high-quality, compassionate care close to home. Anchored by Southern New Hampshire Medical Center, a 188-bed, DNV-accredited hospital in downtown Nashua with a Level III-N trauma center, Level II Special Care Nursery, and Magnet designation for nursing excellence, we offer a full spectrum of services from primary care to advanced diagnostics and specialized treatments. Our medical staff includes over 500 providers from Foundation Medical Partners and local practices. Foundation Medical Partners, our multi-specialty group, spans 70+ practices across southern New Hampshire and northern Massachusetts, providing coordinated, patient-centered care to thousands each year.
About the Job
The Coding Specialist - Hospital Based, Emergency Department is responsible for reviewing and analyzing Emergency Department medical records to accurately assign ICD-10-CM, CPT, and HCPCS codes for both professional and facility services. This role supports compliant, timely, and optimized reimbursement through a single-path ED coding workflow while ensuring adherence to official coding guidelines, regulatory requirements, and payer-specific rules. The position collaborates closely with Emergency Department providers, clinical staff, CDI, and revenue cycle partners.
What You’ll Do
- Review and analyze Emergency Department clinical documentation to assign accurate ICD-10-CM, CPT, and HCPCS codes for professional and facility components
- Assign appropriate ED Evaluation & Management (E/M) levels using current medical decision-making and/or time-based guidelines
- Code ED procedures, including injections, infusions, laceration repairs, splinting, and other emergency services
- Apply modifiers, units, NCCI edits, and payer-specific billing rules to ensure compliant charge capture
- Validate documentation completeness and initiate provider queries when clarification is required
- Serve as a subject matter expert in ED-specific coding and reimbursement methodologies
- Collaborate with providers, clinical teams, CDI, and revenue cycle partners to resolve coding and documentation issues
- Abstract and enter coded data into Epic and other coding/billing systems within established turnaround times
- Monitor trends in documentation quality, coding accuracy, and denials; communicate findings to leadership
- Maintain productivity and quality benchmarks within ED single-path workflows
- Stay current on regulatory updates, coding guideline changes, and payer requirements
Who You Are / Requirements
Required
- High School diploma or equivalent
- Certified Coding Specialist (CCS) or Certified Outpatient Coder (COC)
- Minimum of two (2) years of Emergency Department coding experience in an acute care hospital setting
- Strong working knowledge of ICD-10-CM, CPT, and HCPCS coding systems
- Understanding of ED reimbursement methodologies, including APCs, RVUs, and payer edits
- Proficiency with Epic and encoder/coding software
- Strong analytical, organizational, and communication skills
- Ability to work independently while meeting productivity and accuracy standards
- Commitment to confidentiality, HIPAA compliance, and ethical coding practices
Preferred
- Associate degree in Health Information Management or related field
- Additional HIM certifications (RHIT, RHIA)
Why You’ll Love Us
- Southern NH Medical Center is a 5-time Magnet designated hospital
- Health, dental, prescription, and vision coverage for full-time & part-time employees
- Medical, dental, and vision coverage
- Life insurance
- Short- and long-term disability
- Flexible Spending Accounts (FSA)
- Competitive pay
- Tuition Reimbursement
- Nursing Student Loan Paydown Program
- 403(b) Retirement Savings Plan
- Education & paid training courses for continued career progression
- & so much more!
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