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Certified Medical Coding Specialist – Professional Based
Elliot HospitalCoding Specialist analyzing and assigning ICD-10-CM, CPT, and HCPCS codes for professional medical encounters at Southern New Hampshire Health. Ensuring compliance with coding guidelines to optimize reimbursement and minimize denials.
ATS Keywords
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Hard Skills
ICD-10-CM codingCPT codingHCPCS codingCPT modifierscoding accuracycoding compliancecoding guidelinesmedical terminologyanatomyphysiology
Soft Skills
analytical skillsproblem-solving skillswritten communicationverbal communication
Tools & Technologies
Epiccoding softwareencoder software
Certifications & Qualifications
Certified Coding Specialist (CCS)Certified Professional Coder (CPC)Certified Coding Specialist – Physician-Based (CCS-P)Registered Health Information Technician (RHIT)Registered Health Information Administrator (RHIA)
Industry Keywords
professional codingmultispecialty physician settingregulatory complianceCMSHIPAA
About the role
Key responsibilities & impact- Review and analyze professional medical records, including office visits, hospital-based professional services, and outpatient encounters
- Assign accurate ICD-10-CM, CPT, and HCPCS codes
- Apply appropriate CPT modifiers, units, place of service indicators, and payer-specific billing rules
- Abstract and enter coded data into Epic and other professional billing and coding systems
- Ensure compliance with official coding guidelines, regulatory requirements, payer policies, and organizational standards
- Maintain a minimum coding accuracy rate of 95% and meet established productivity benchmarks
- Review, investigate, and resolve claim edits and coding-related errors
- Validate provider documentation and query providers for clarification or additional detail when needed
- Serve as a subject matter expert for professional coding, including E/M services, procedure coding, and modifier usage
- Collaborate with providers, clinical staff, educators, and revenue cycle teams to resolve coding and documentation issues
- Monitor and communicate coding and documentation trends impacting professional billing and compliance
- Stay current on coding updates, regulatory changes, and professional billing requirements
- Participate in audits, education, training, and continuous improvement initiatives
- Perform other duties as assigned
Requirements
What you’ll need- High School diploma or equivalent required
- Associate degree in Health Information Management or a closely related field preferred
- Certification (Required at Time of Hire) Certified Coding Specialist (CCS), or Certified Professional Coder (CPC), or Certified Coding Specialist – Physician-Based (CCS-P)
- Additional HIM certifications (RHIT, RHIA) preferred
- Minimum of two (2) years of professional coding experience in a multispecialty physician setting
- Experience with ICD-10-CM, CPT, and HCPCS coding systems
- Knowledge of professional coding guidelines and compliant coding practices
- Knowledge of medical terminology, anatomy, physiology, and regulatory compliance (CMS, HIPAA)
- Proficiency with Epic and coding/encoder software preferred
- Strong analytical, problem-solving, written, and verbal communication skills.
Benefits
Comp & perks- Health, dental, prescription, and vision coverage for full-time & part-time employees
- Life insurance
- Short- and long-term disability
- Flexible Spending Accounts (FSA)
- Competitive pay
- Tuition Reimbursement
- Nursing Student Loan Paydown Program
- 403(b) Retirement Savings Plan
- Education & Paid training courses for continued career progression
- So much more!