Coding Specialist - Surgical Services

Integrative Emergency Services, LLC ("IES") is seeking a Coding 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 RESPONSIBILITIES

The 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 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) (ie. CCS‑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

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 disabilities. In 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 View email address on click.appcast.io. #J-18808-Ljbffr Integrative Emergency Services