Certified Coding Escalation Specialist

Job Summary

Resolving complex coding issues, the full-time remote Certified Coding Escalation Specialist will conduct thorough reviews of medical records, ensure accurate code assignment, and provide expert support to the medical coding team while liaising with coders, auditors, and compliance teams.

Key responsibilities

• Review and resolve escalated coding issues from coders, auditors, and providers
• Analyze medical records to ensure accurate and compliant code assignment
• Educate and mentor coding staff on complex cases and updates to coding regulations

Required qualifications

• Minimum 3-5 years of experience in medical coding, with emphasis on complex case review or coding quality assurance
• AAPC or AHIMA certification required
• Expert-level knowledge of ICD-10-CM, CPT, and HCPCS coding systems
• Strong understanding of CMS regulations and payer-specific guidelines
• Experience with electronic health records (EHRs) and coding software systems