Single Path Coding Specialist II; Remote

1.0 FTE Full time Day - 08 Hour R2653892 Remote USA  Rev Cycle Single Path Coding Finance & Revenue Cycle Day - 08 Hour (United States of America). This is a Stanford Health Care job.

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The Single Path Coding (SPC) Specialist-Level 2 is an advanced coder responsible for reviewing clinical documentation to extract data and assign appropriate ICD‑10‑CM diagnostic codes, CPT procedure codes and modifiers, group APCs for billing, and process NCCI and payer‑specific edits related to hospital and professional coding. The SPC coding specialist processes codes for surgical encounters and follows the ICD‑10‑CM Official Guidelines for Coding and Reporting, AHIMA Code of Ethics and Standards of Ethical Coding, and all AHA Coding Clinics for HCPCS and AMA CPT Assistant.

The specialist serves as a subject‑matter expert in hospital and professional coding, interacting with Patient Financial Services, Patient Billing Office, Revenue Integrity (Charge Description Master) Team, provider teams, and Compliance on a routine basis. Responsibilities include reviewing and resolving medical necessity edits for outpatient surgical encounters, applying modifiers to CPT codes, processing revenue cycle errors, and collaborating on documentation optimization opportunities.

When necessary, the specialist assists in designing and implementing workflow changes to reduce coding and billing errors. The SPC Specialist II is distinguished from the I level by mastering more than one specialty and/or possessing coding certification in two specialties.

Stanford Health Care

• Reviews medical record documentation and accurately assigns appropriate ICD‑10‑CM diagnoses, CPT codes and modifiers for both hospital and professional claims.
• Validates and processes any medical necessity edits (local or national coverage determinations) for hospital and professional coding.
• Processes coding‑related payer‑specific edits for hospital and professional claims.
• Communicates effectively with provider teams; serves as an advocate for documentation improvement.
• Follows established coding conventions and guidelines set forth by State and Federal regulations.
• Monitors Discharged Not Billed accounts and ensures timely, compliant processing of outpatient and inpatient encounters.
• Maintains established quality and productivity standards.
• Performs responsibilities independently, without direct supervision.
• Exhibits strong time‑management, problem‑solving and communication skills.
• Demonstrates critical thinking, good judgment and decision‑making.
• Shows excellent written and oral communication.
• Stays abreast of CMS requirements, NCCI edits, NCDs, LCDs and payer‑specific edit processing to ensure clean claim submission.
• Follows all Stanford Health Care policies and procedures.
• Attends required system, hospital and departmental meetings and educational sessions, and completes required annual learning programs.
• Abides by Joint Commission requirements, including cultural diversity, patient care and safety, emergency management, teamwork, respect, training, safety and quality programs, and National Patient Safety Goals.
• Performs duties in accordance with the C‑I‑CARE Standards of the Hospital.

• Associate Degree in a work‑related discipline/field or an equivalent combination of education and work experience.

• Five years; must be proficient in coding surgical encounter specialties.
• Currently holds role‑related certifications such as RHIA, RHIT, CCS, CCS‑P, CPC, COC or other coding certification in a specialized area, or CIRCC for advanced Interventional Radiology/Interventional Cardiology coding.

• Successful completion of the Coder Proficiency Exam (pre‑hire).
• Consistently meets department quality and productivity standards.
• Develops and maintains collaborative relationships with physicians and clinical professionals.
• Adapts to change and ambiguity.
• Plans, organizes, prioritizes, works…