Brown University Health

Remote behavioral health care platform analytics

Coding Specialist

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours

Full-timeRemote in USA$24.29 - $40.07

About the Job

Requirements

A high school diploma or equivalent is required.
At least one of the following certifications is required: Certified Professional Coder (CPC) from AAPC, Certified Coding Specialist (CCS) from AHIMA, or Certified Coding Specialist–Physician-based (CCS-P) from AHIMA.
One to three or more years of professional physician-based coding experience is required.
Strong knowledge of ICD-10-CM, CPT, and HCPCS Level II coding guidelines is required.
Knowledge of medical terminology, anatomy, and healthcare documentation is required.
Ability to interpret complex medical documentation and accurately apply coding guidelines is required.
Written and verbal communication skills are required.
Proficiency with electronic health records is required.
Experience with E/M coding and/or surgical or procedural coding is required.
Ability to maintain a secure, private workspace and use organization-approved secure systems, including VPN and multi-factor authentication, is required.
Ability to work independently within departmental policies and practices and refer complex policy or procedure questions to a supervisor is required.
Ability to meet deadlines while achieving productivity and accuracy standards is required.

Responsibilities

Review, interpret, and assign ICD-10-CM, CPT, and HCPCS Level II codes for physician and other qualified healthcare provider services to support accurate reimbursement and reduce audit risk.
Enter coded and abstracted information into 3M 360 Finder, assign accurate APC codes, and review coding edits in 3M.
Follow National Correct Coding Initiative edits and applicable medical necessity requirements, resolve accounts on the claims edit database, and assign injection and infusion codes for observation patients.
Meet minimum productivity standards and maintain an average coding accuracy rating of 95%.
Assign E/M, ICD-10-CM, CPT, or chargemaster codes to clinic visits and ensure medical record documentation supports the assigned codes.
Verify diagnoses and codes entered by physicians for accuracy and documentation support, use 3M to identify and resolve NCCI edits before final billing, and report documentation insufficiencies to the responsible physician.
Follow Rhode Island Hospital Facility Coding Guidelines for adult patients and 1995 Evaluation and Management Guidelines for patients under 18 years of age.
Monitor and resolve rejected accounts on claims edit and eClinicalWorks error reports within established timeframes by researching coding conflicts, chargemaster issues, medical necessity, and other coding and billing issues.
Refer complex coding issues to the coding validator or supervisor.
Review outpatient uncoded reports, research and resolve old uncoded accounts and accounts with inappropriate charges, update patient financial accounts in the Patient Management and Patient Accounting billing system as required, and follow established rebilling procedures.
Perform related clerical duties and maintain knowledge and expertise pertinent to the position.
Maintain compliance with CMS regulations, NCCI edits, Medicare Administrative Contractor guidance, payer policies, and organizational policies.
Participate in compliance initiatives to reduce coding-related denials and audit findings.
Comply with HIPAA and organizational data privacy and security policies.
Ensure query compliance and appropriateness in accordance with ACDIS/AHIMA Guidelines for Achieving a Compliant Query Practice.
Follow the Standards of Ethical Coding set forth by the American Health Information Management Association and the American Association of Professional Coders.
Meet or exceed a 95% coding accuracy rate and achieve productivity benchmarks while performing accurately, on time, and within workload expectations.
Adhere to organizational coding guidelines, payer requirements, and documentation standards to support audit readiness and reimbursement integrity.
Accurately resolve coding edits, denials, and discrepancies.
Protect protected health information using secure systems and maintain active communication through email, messaging platforms, and scheduled virtual meetings.

Desired Qualifications

Specialty coding experience is a plus.
Epic experience is preferred.

SUMMARY:

Reporting to the Manager of Professional Coding, the Professional Coding Specialist is responsible for the accurate review, interpretation, and assignment of ICD-10-CM, CPT, and HCPCS Level II codes for physician and other qualified healthcare provider services. This role ensures coding accuracy and compliance with federal regulations, payer guidelines, and organizational policies to support appropriate reimbursement and minimize audit risk.
The Coding Specialist collaborates with providers, revenue cycle teams, and clinical teams to ensure complete, accurate, and compliant documentation and coding practices.
Reporting to the Manager of Professional Coding, the Professional Coding Specialist is responsible for the accurate review, interpretation, and assignment of ICD-10-CM, CPT, and HCPCS Level II codes for physician and other qualified healthcare provider services. This role ensures coding accuracy and compliance with federal regulations, payer guidelines, and organizational policies to support appropriate reimbursement and minimize audit risk.
The Coding Specialist collaborates with providers, revenue cycle teams, and clinical teams to ensure complete, accurate, and compliant documentation and coding practices.

Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another.

In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:

Instill Trust and Value Differences
Patient and Community Focus and Collaborate

RESPONSIBILITIES:

Enters codedbstracted information into 3M 360 Finder assigning accurate APC and reviewing all coding edits appearing in 3M. Understands and follows all National Correct Code Initiative Edits (NCCI) and follows pertinent medical necessity requirements. Resolves accounts on the claims edit database. Assigns injections and infusion codes for observation patients. Meets the minimum productivity standard mintaining an average accuracy rating of 95%.
Assigns E/M, ICD-10-CM, CPT or chargemaster codes to clinic visits ensuring medical record documentation supports the code. Should physicians have entered in diagnosis, ICD or CPT codes, ensures they are accurate and supported by documentation in the medical record. Utilizes 3M to identify and resolve NCCI edits before final billing. Reports documentation insufficiencies to the responsible physician. Follows Rhode Island Hospital Facility Coding Guidelines for adult patients and 1995 Evaluation and Management Guidelines for patients less than 18 years of age.
Monitors and resolves rejected accounts on the Claims Edit Report and e Clinical Works error reports by established timeframe researching coding conflicts including chargemaster, medical necessity and various other coding and billing issues. Refers complex coding issues to the coding validator or supervisor.
Reviews pertinent outpatient uncoded reports researching and resolving old uncoded accounts and any accounts posted on report for which the charges are inappropriate. Updates patient financial accounts in the Patient Management and Patient Accounting billing system as required. Follows established procedures for rebilling accounts.
Performs related clerical duties as required.
Maintains level of knowledge and expertise pertinent to the position.

Compliance & Regulatory Adherence

Maintain compliance with CMS regulations, National Correct Coding Initiative (NCCI) edits, Medicare Administrative Contractor (MAC) guidance, payerpoliciesandorganizational policies.

Participate in compliance initiatives to reduce coding-related denials and audit findings.

Ensurescompliance with HIPAA,organizational data privacy,and security policies.

Query compliance and appropriatenessin accordance withACDIS/AHIMA Guidelines for Achieving a Compliant Query Practice

Abides by the Standards ofEthical Coding as set forth by the American Health Information ManagementAssociation and the American Association of Professional Coders.

Performance Metrics

Meets or exceeds 95%codingaccuracy rate

Achievesproductivity benchmarks

Demonstratesconsistent performance in accuracy, timeliness, and workload management

Adheresto organizational coding guidelines, payer requirements, and documentation standards to support audit readiness and reimbursement integrity

Accurately resolvescoding edits, denials, and discrepancies

MINIMUM QUALIFICATIONS:

Education

High school diploma or equivalent required

Certifications

One or more of the following required:

CPC (Certified Professional Coder) – AAPC

CCS or CCS-P (Certified Coding Specialist / Physician-based) – AHIMA

Experience

1–3+ years of professional (physician-based) coding experience

Specialty experience a plus Strong knowledge of: ICD-10-CM, CPT, and HCPCS Level II coding guidelines
Medical terminology, anatomy, and healthcare documentation
Ability to interpret complex medical documentation and apply coding guidelines accurately
Strong written and verbal communication skills
Proficiencywith electronic health records (EHR), Epic experiencepreferred
E/M coding and/or surgical/procedural coding

Work Environment

Fully Remote: Must maintain a secure, private workspace to protect PHI.Required to use organization-approved secure systems (VPN, multi-factor authentication).Maintains active communication via email, messaging platforms, andattendsvirtual meetings, as scheduled.

Working conditions:Requireslong periodsof computer use to review medical records. Ability to meet deadlines while achieving productivity and accuracy standards.

Independent action:Demonstratesability to work independentlywithin the department’s policies and practices.Refersspecific complex problems to the supervisor when clarification of the departmental policies and procedures arerequired.

Supervisory responsibility:None

Disclaimer

This job description is intended to describe the general nature and level of work performed. Duties and responsibilities may be adjusted based on organizational needs and regulatory requirements.

Pay Range:

$24.29-$40.07

EEO Statement:

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

Location:

Corporate Headquarters - 15 LaSalle Square Providence, Rhode Island 02903

Work Type:

M-F 8am-4:30pm

Work Shift:

Day

Daily Hours:

8 hours

Driving Required:

About the Company

Brown University Health

Remote behavioral health care platform analytics

Memoir Health built a behavioral healthcare platform for home-based care, helping healthcare organizations manage patients remotely. The platform includes remote patient monitoring, scheduling, virtual care, and outcomes management, powered by a data analytics engine that highlights cost-saving opportunities and guides proactive care. It stands out by automating care journeys and delivering integrated, outcomes-focused care within managed care networks, reducing administrative work for clinicians. Its goal is to make care more proactive, accessible, and coordinated from home, aiming to improve patient outcomes while lowering costs; Memoir Health was acquired by Lumeo Health in 2020.

Company size: 1-10
Company stage: Seed
Total funding: $7.5M
Headquarters: New York City, New York
Founded: 2018

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