Coding Specialist
Cass Health
Coding Specialist Full-Time (80 hours a pay period) | Revenue Integrity Schedule: Monday-Friday, set schedule upon hire
Work Arrangement: Hybrid/Remote options available following successful completion of the probationary period What You'll Do As a Coding Specialist, you will play a critical role in ensuring accurate, compliant, and timely coding of hospital, clinic, and professional services. Working under the direction of the Director of Revenue Integrity and with day-to-day guidance from the Revenue Integrity Lead, you will review clinical documentation, assign appropriate codes, resolve coding edits, and support clean claim submission while helping optimize reimbursement and regulatory compliance. In this role, you will:
For further information, please review the Know Your Rights notice from the Department of Labor.
Work Arrangement: Hybrid/Remote options available following successful completion of the probationary period What You'll Do As a Coding Specialist, you will play a critical role in ensuring accurate, compliant, and timely coding of hospital, clinic, and professional services. Working under the direction of the Director of Revenue Integrity and with day-to-day guidance from the Revenue Integrity Lead, you will review clinical documentation, assign appropriate codes, resolve coding edits, and support clean claim submission while helping optimize reimbursement and regulatory compliance. In this role, you will:
- Review health records and assign accurate ICD-10-CM, ICD-10-PCS, CPT, HCPCS, modifier, and other required coding elements for assigned service lines.
- Apply official coding guidelines, Coding Clinic guidance, CPT guidance, National Correct Coding Initiative (NCCI) edits, CMS requirements, payer policies, and organizational procedures.
- Sequence diagnoses and procedures appropriately and abstract required clinical, demographic, and billing information into Epic and other approved systems.
- Review coding and claim-edit work queues, resolving assigned edits and escalating complex issues as appropriate.
- Evaluate documentation for coding support and initiate compliant provider clarification or query processes when information is incomplete, conflicting, or ambiguous.
- Identify potential documentation, charge capture, medical necessity, coverage, reimbursement, or workflow concerns and refer issues to the appropriate resources.
- Collaborate with Revenue Integrity Specialists, Health Information Management, Patient Financial Services, clinical departments, and Prior Authorization teams to resolve documentation and billing concerns.
- Provide coding expertise for claim corrections, appeals, denial reviews, and reimbursement-related questions.
- Analyze coding denials, recurring edits, and trends, helping identify opportunities for education and process improvement.
- Participate in internal and external coding audits and complete corrective action plans or education as needed.
- Maintain established productivity, accuracy, quality, and turnaround time expectations.
- Stay current on coding regulations, annual code updates, payer requirements, and specialty-specific coding guidelines.
- Assist with developing coding education materials, job aids, and documentation guidance.
- Clearly document coding decisions, research findings, provider queries, and escalations.
- Protect patient information and maintain compliance with HIPAA, coding ethics, and organizational confidentiality standards.
- Perform all other duties as assigned.
- High School Diploma or equivalent
- Associate or Bachelor's degree in Health Information Management, Healthcare Administration, or a related healthcare field
- One of the following coding credentials:
- Certified Professional Coder (CPC)
- Certified Coding Specialist (CCS)
- Certified Coding Specialist – Physician-Based (CCS-P)
- Registered Health Information Technician (RHIT)
- Or another comparable coding certification
- Ability to research coding questions and interpret authoritative coding guidance
- Strong understanding of coding regulations, reimbursement methodologies, and compliance requirements
- Ability to identify documentation gaps and initiate compliant provider queries
- Excellent attention to detail and commitment to coding accuracy
- Strong organizational, communication, and problem-solving skills
- Ability to manage competing priorities and meet productivity expectations
- Ability to work independently while maintaining collaboration with cross-functional teams
- Commitment to confidentiality, professionalism, and ethical coding practices
- Three or more years of healthcare coding experience
- Experience with hospital, critical access hospital, rural health clinic, physician, or specialty coding
- Experience with Epic or similar electronic health record systems
- Experience using encoder or coding-assistance technology
- Experience supporting denial management, appeals, or revenue cycle operations
- Top 100 Critical Access Hospital every year since 2017
- Top 20 Critical Access Hospital every year since 2021
- Top Iowa Workplace for more than a decade
- HFMA MAP Award Winner for Revenue Cycle Performance (2021)
- Medical and dental insurance
- Employer-paid life insurance
- Long-term disability coverage
- Participation in IPERS
- Optional 403(b) retirement plan
- Generous paid time off
- Short-term disability benefits
- Tuition reimbursement
- Continuing education and professional development opportunities
For further information, please review the Know Your Rights notice from the Department of Labor.
Vacancy posted 4 days ago
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