Coding Specialist

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The Coding Specialist reports to the Manager of Physician Coding and ensures that appropriate diagnostic and procedural codes (CPT-4, ICD-9/10, HCPCS) are submitted for professional charges. This role supports accurate claims processing, data retrieval, and analysis while role modeling the organization’s values of Compassion, Accountability, Respect, and Excellence.

• Assess the adequacy of the documentation for provider visits or procedures to support diagnoses.
• Review procedure codes selected by providers for hospital services and complex office services, all diagnoses for medical necessity and adequate specificity.
• Query providers when documentation is inadequate, unclear, or does not support the code assigned.
• Correct and revise codes as necessary to ensure compliance with federal law, payer guidelines, and requirements for optimal reimbursement.
• Refer coding, billing, and system questions to the Manager after exhausting own efforts.
• Perform audits of provider coding and documentation and educate providers regarding improvement.
• Remain current with coding guidelines and documentation requirements.
• Maintain coding certification by earning required continuing education units.

• High school diploma or equivalent.
• Formal education in medical coding and certification from the American Academy of Professional Coders (AAPC), American Health Information Management Association (AHIMA), or other association.
• One year of medical billing experience in a hospital, medical office, or billing company; coding experience preferred.
• Training in anatomy, physiology, and disease processes preferred.
• Strong writing skills to prepare physician queries.
• Computer skills to research internet websites and access payer policies.
• Proficiency with Excel, Word, Adobe Reader, Microsoft Outlook, and third‑party payer websites;
  Epic experience a plus.

$21.61-$35.66

Brown University Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, ethnicity, sexual orientation, ancestry, genetics, gender identity or expression, disability, protected veteran, or marital status. Brown University Health is a VEVRAA Federal Contractor.

BHCS 15 LaSalle Square - Providence, Rhode Island 02903

Per Diem

Day

Per Diem - As required

No