Certified Medical Coding Specialist

Job Summary

A company is looking for a Medical Coding Specialist responsible for billing analysis and ensuring compliance with coding standards and regulations.

Key Responsibilities

• Review and analyze billing for medical appropriateness and compliance
• Apply national coding standards to claims and prepare findings
• Monitor trends and communicate clinical education related to claims

Required Qualifications

• Minimum of a Bachelor's Degree in a healthcare-related field or completion of medical coding certification
• Current nursing certification or coding certification (CCS, CCS-P, CPC, RHIA/RHIT)
• At least 2 years of experience in medical billing, coding, or auditing
• Knowledge of inpatient/outpatient billing requirements and coding systems (CPT, HCPCS, ICD-9/10)
• Understanding of payer reimbursement policies and medical necessity criteria