4529- Coding Specialist

Ovii's Interpretation of the Role

The Coding Specialist I reviews, codes, and resolves front‑end health‑care claims to ensure accurate, timely reimbursement. The role demands strong knowledge of ICD‑10‑CM, CPT, and payer guidelines while maintaining high coding accuracy and HIPAA compliance.

Role Snapshot

• Medical coding of front‑end claims
• Assign ICD‑10‑CM and CPT codes with modifiers
• Maintain ≥90% coding accuracy
• Resolve claim holds independently
• Ensure HIPAA and payer compliance
• Collaborate with revenue‑cycle partners

Must-Have Requirements

• Current AAPC or AHIMA certification
• 3+ years professional coding experience
• Strong working knowledge of CPT, ICD‑10‑CM, medical terminology, and Medicare reimbursement guidelines
• Familiarity with proper English grammar and professional documentation standards
• Ability to research, analyze data, and resolve coding issues
• Proficiency with Microsoft Office Suite (Word, Excel, Outlook, Teams)
• Understanding of HIPAA privacy and confidentiality requirements
• medical coding
• front‑end claim processing
• AAPC certification
• AHIMA certification
• Must hold a current AAPC or AHIMA certification
• Must be authorized to work in the United States (E‑Verify)

Work Setup

• Location: United States
• Work mode: REMOTE
• Remote scope: COUNTRY_RESTRICTED
• Remote countries: United States
• Employment type: Full-Time

Eligibility Gates

• Work authorization: Must be authorized to work in United States
• Visa sponsorship: no

Not Specified in JD

• Salary range
• Visa sponsorship
• Relocation
• Notice period
• Travel
• Security clearance
• Coding test
• Portfolio
• GitHub
• Writing sample
• Cover letter

What You'll Likely Work On

• Review medical records and assign appropriate ICD‑10‑CM and CPT codes with modifiers for professional‑fee services
• Analyze and resolve front‑end claim holds to achieve clean claim rates
• Maintain a minimum of 90% coding accuracy and meet required CEU credits
• Ensure all coding decisions comply with payer policies, medical necessity guidelines, and HIPAA privacy standards
• Collaborate with revenue‑cycle partners and the Coding Team Lead to address trends and escalations
• Generate reports and documentation to support coding validation and compliance

Good Fit If You Have

• Strong attention to detail and independent judgment in coding decisions
• Ability to interpret medical documentation and apply coding guidelines
• Excellent written and verbal communication for interacting with physicians and staff