Certified Coding Specialist II | Part-Time | Hybrid WFH

Certified Coding Specialist II

Behind every award is a story, and ours is written every day by more than 900 dedicated employees and hundreds of compassionate volunteers who walk alongside patients and families when they need us most.

At Community Hospice & Palliative Care, we're honored to be recognized with the Hospice Honors Elite award, a testament not just to our clinical excellence, but to the compassion we bring to every bedside, every home, every conversation. Every day, we serve approximately 1,500 patients living with advanced illness, wherever they call home, be it a private residence, a long-term care or assisted living facility, a hospital, or in one of our nine inpatient care centers.

We're here to improve quality of life, to ease pain and lift burdens, and to be the Compassionate Guide that families need when time matters most. And most importantly, as the only non-profit hospice provider in the region, we never turn anyone away due to an inability to pay.

The Certified Coding Specialist II reviews, analyzes, and codes diagnostic and procedural information that determines Medicare, Medicaid, and private insurance reimbursement. This position serves as an advanced coding subject matter expert, supports provider education, performs audits, supports risk adjustment initiatives, and may assume departmental leadership in the absence of the Medical Coding Manager.

Position Details

• Work Location: Work From Home 100% or in person at Community Hospice and Palliative Care main location, 4266 Sunbeam Road Jacksonville FL.
• Hours: Part-Time, 20-25 hours per week
• Days: Between Monday - Friday, 8:00am - 5:00pm; actual work days/hours TBD worked out with manager/candidate at time of hire
• Compensation: $18.50 - $23.00 hour

Primary Responsibilities:

• Reviews, analyzes, abstracts, and translates provider documentation to assign accurate CPT, HCPCS, E/M, and modifier codes.
• Reviews, analyzes, abstracts, and sequences of ICD-10-CM diagnosis codes.
• Identifies and captures applicable Hierarchical Condition Categories (HCCs), chronic conditions, and risk-adjusted diagnoses in accordance with CMS and payer-specific guidelines.
• Performs HCC (Hierarchical Condition Category) risk adjustment coding activities for PACE (Program of All-Inclusive Care for the Elderly), Advanced Illness Program (AIP), and other applicable organizational programs.
• Provides coding support for Hospice, inpatient and outpatient Palliative Care, Alivia Supportive Care (ASC), Chronic Care Management (CCM) GUIDE, and future organizational programs.
• Extracts MIPS quality measures and other value-based reporting elements from provider documentation.
• Queries providers when documentation is incomplete, ambiguous, or insufficient for coding, compliance, or quality reporting.
• Conducts coding-related audits including prospective audits for Palliative Care, GUIDE, and other programs to ensure documentation accuracy, coding integrity, and risk adjustment capture.
• Identifies high-performing providers who may qualify for temporary audit exemption based on sustained documentation accuracy while continuing periodic monitoring.
• Develops, implements, and delivers provider documentation education for physicians and Advanced Practice Registered Nurses (APRNs), including:
• Orientation and annual training
• One-on-one education in clinical settings
• Identification of documentation improvement opportunities
• Monitoring effectiveness through follow-up audits
• Reporting outcomes to leadership
• Serves as a coding and compliance subject matter expert for Certified Coding Specialist I staff and providers.
• Works closely with Charge Entry and Billing teams to ensure timely and accurate charge submission.
• Reviews Additional Documentation Requests (ADRs) and payer audit requests from Medicare, Medicaid, and commercial payers.
• Assists with development of weekly and monthly departmental reports (coding, audit, productivity, and compliance).
• Maintains knowledge of CMS regulations, coding guidelines, payer policies, NCCI edits, and reimbursement requirements.
• Supports compliance, revenue integrity, and quality improvement initiatives.
• Provides mentoring and support to Certified Coding Specialist I staff.
• In the absence of the Medical Coding Manager, assumes departmental oversight includes workflow coordination and staff supervision as assigned.
• Performs special projects and other duties supporting Medical Coding, Compliance, and Revenue Cycle operations.

Required Licenses/Certifications:

• Certified Professional Coder (CPC) required
• Certified Risk Adjustment Coder (CRC) required
• Current Florida Driver's License (acceptable driving record)
• AHCA Level 2 Background Screening (eligible status required)

Education/Experience: A combination of education and experience that would provide required skills and knowledge for successful job performance would be considered. Typical qualifications would be equivalent to:

• Associate degree preferred
• Coding program or CPC prep required
• 35 years coding experience required
• Experience with auditing and provider education preferred
• Experience with risk adjustment/HCC coding strongly preferred
• Experience in Hospice, Palliative Care, ASC, or value-based programs preferred
• Leadership or mentoring experience preferred

Skills/Competencies:

Advanced CPT, ICD-10-CM, HCPCS, and E/M coding proficiency Strong understanding of CMS regulations, HCC/risk adjustment, and MIPS Strong auditing and analytical skills Provider education and communication skills Microsoft Office (advanced Excel preferred) Strong organizational and critical thinking skills Ability to manage multiple priorities and work independently

Community Hospice & Palliative Care, including all of its subsidiaries and affiliated companies, is committed to complying with all applicable provisions of the Americans with Disabilities Act (ADA), as amended. We provide reasonable accommodations to qualified individuals with disabilities to ensure equal access to employment opportunities and the ability to perform the essential functions of a position. If you require an accommodation to complete the application process, interview, or perform the essential functions of a role, please contact Human Resources.

We participate in E-Verify to confirm the employment eligibility of all newly hired employees. Equal Opportunity Employer