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Senior Coder Specialty

  • Texas, Tyler

  • 11/10/2025

  • Contract

  • Active

Job Description:

  • The Senior Coder – Specialty is responsible for accurately coding complex medical records in accordance with official coding guidelines and payer-specific requirements. This role ensures that all documentation is complete and compliant to support accurate billing, reimbursement, and data integrity within the healthcare organization. The Senior Coder serves as a subject matter expert in specialty coding areas (such as surgery, cardiology, orthopedics, oncology, or other clinical specialties) and provides guidance and training to coding staff to ensure consistent quality and accuracy.

    Key Responsibilities
    1. Review and analyze medical documentation to assign appropriate ICD-10-CM, CPT, and HCPCS codes for diagnoses, procedures, and services.
    2. Ensure coding accuracy and compliance with federal regulations, payer requirements, and organizational policies.
    3. Perform quality assurance reviews and audits of coded data to ensure adherence to coding standards.
    4. Identify and resolve documentation deficiencies by working collaboratively with physicians, clinical staff, and revenue cycle teams.
    5. Assist in optimizing clinical documentation to improve coding accuracy and reimbursement outcomes.
    6. Maintain current knowledge of coding guidelines, regulatory updates, and payer policy changes.
    7. Support the development and implementation of coding education and training programs for coding staff and clinical providers.
    8. Serve as a resource for complex coding questions and provide specialty-specific coding expertise.
    9. Contribute to performance improvement initiatives related to revenue integrity and compliance.
    10. Meet productivity and accuracy benchmarks established by the department.

    Required Qualifications
    1. Education: Associate’s degree in Health Information Management, Nursing, or related field; or equivalent combination of education and experience.
    2. Experience: Minimum of 3–5 years of progressive coding experience, including specialty or complex coding assignments in a healthcare setting.
    3. Strong understanding of medical terminology, anatomy, physiology, and disease processes.
    4. In-depth knowledge of ICD-10-CM, CPT, and HCPCS coding systems and official coding guidelines.
    5. Demonstrated ability to interpret clinical documentation and apply accurate codes with minimal supervision.

    Preferred Qualifications
    1. Experience coding in one or more specialty areas (e.g., cardiology, orthopedics, oncology, neurology, or surgery).
    2. Previous experience in coding audits, revenue integrity, or physician education.
    3. Knowledge of Epic, 3M, or similar electronic health record (EHR) and coding software systems.

    Certifications
    1. Required: Active certification from one of the following:
    2. Certified Professional Coder (CPC) – AAPC
    3. Certified Coding Specialist (CCS) – AHIMA
    4. Certified Coding Specialist–Physician-based (CCS-P) – AHIMA
    5. Preferred: Additional specialty coding credentials (e.g., COC, CIC, or specialty-specific AAPC credentials).

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