About this role
Position Summary
We are seeking an experienced Professional Fee Coding Specialist for a short-term backlog remediation project estimated to last approximately one month . This role will primarily focus on ICD-10-CM diagnosis coding and diagnosis-related edit resolution for a nationally recognized Children's Hospital supporting multiple physician specialties.
The ideal candidate will possess strong diagnosis coding expertise, particularly with injury-related encounters, and demonstrate proficiency in reviewing coding edits related to diagnosis specificity, laterality, 7th character assignment, modifiers, and CPT coding accuracy.
Key Responsibilities
- Perform comprehensive ICD-10-CM diagnosis coding and coding validation for professional fee services.
- Review and resolve diagnosis-related coding edits to ensure accuracy and compliance.
- Apply and validate appropriate 7th character assignment , diagnosis specificity, and laterality requirements.
- Analyze and correct coding issues associated with injury-related encounters and treatment episodes.
- Review and address modifier and CPT-related edits as necessary.
- Ensure accurate code assignment based on provider documentation and coding guidelines.
- Maintain productivity and quality standards while supporting backlog reduction efforts.
- Collaborate with coding leadership and quality teams to address coding questions and documentation concerns.
- Adhere to official coding guidelines, payer requirements, and organizational compliance standards.
Required Qualifications
- Minimum 2 years of Professional Fee coding experience .
- Strong expertise in ICD-10-CM diagnosis coding .
- Demonstrated experience with: Injury-related diagnosis coding
- 7th character assignment
- Diagnosis specificity requirements
- Laterality guidelines
- Modifier review and application
- CPT-related edit resolution
- Experience working across multiple physician specialties.
- Proficiency with Epic and 3M 360 Encompass (required).
- Strong analytical and critical-thinking skills with excellent attention to detail.
- Ability to work independently in a remote environment while maintaining productivity and quality expectations.
Preferred Qualifications
- Experience coding for a Children's Hospital or pediatric patient population.
- Familiarity with Radiology Professional Fee Coding .
- Professional coding credential preferred: CPC
- CCS-P
- RHIT
- RHIA
- CIRCC (if radiology experience is present)
Project Details
- Project Duration: Approximately 1 month (backlog cleanup initiative).
- Primary Focus: ICD-10-CM diagnosis coding and diagnosis-related edits.
- Secondary Focus: Modifier review and CPT-related edits.
- Patient Population: Pediatric.
- Specialties: Multiple physician specialties.
Training & Schedule
- Initial Training: Must be available during standard business hours between 8:00 AM and 4:00 PM PST .
- Post-Training Schedule: Flexible scheduling may be available based on project needs and management approval.
Work Environment
This is a remote project supporting a high-volume pediatric healthcare organization. Successful candidates will possess strong diagnosis coding skills, excellent attention to detail, and the ability to efficiently work through complex coding backlogs while maintaining exceptional coding quality and compliance standards.
Required Qualifications
- Minimum 2 years of Professional Fee coding experience .
- Strong expertise in ICD-10-CM diagnosis coding .
- Demonstrated experience with: Injury-related diagnosis coding
- 7th character assignment
- Diagnosis specificity requirements
- Laterality guidelines
- Modifier review and application
- CPT-related edit resolution
- Experience working across multiple physician specialties.
- Proficiency with Epic and 3M 360 Encompass (required).
- Strong analytical and critical-thinking skills with excellent attention to detail.
- Ability to work independently in a remote environment while maintaining productivity and quality expectations.