Stanford Health Care is hiring a Single Path Coding Specialist II (Remote)

Stanford Health Care (SHC) is seeking a Single Path Coding Specialist II to join our team. This advanced remote coding role is responsible for reviewing clinical documentation to assign ICD-10-CM and CPT codes, group APCs, and process NCCI and payer edits for both hospital and professional billing. You will serve as a subject matter expert, interacting with various teams and providers, and ensuring compliance with all coding guidelines and regulations.

What You'll Do

• Review medical record documentation and accurately assign appropriate ICD-10-CM diagnoses, CPT codes, and modifiers for hospital and professional claims.
• Validate and process any medical necessity edits (local or national coverage determinations) that may apply.
• Process coding-related payer specific edits for the hospital and professional claim.
• Communicate effectively with provider teams across the organization and serve as an advocate for documentation improvement.
• Follow established coding conventions and guidelines as set forth by State and Federal regulations.
• Monitor Discharged Not Billed accounts and ensure timely, compliant processing of outpatient and inpatient encounters.
• Maintain established quality and productivity standards.
• Remain abreast of current CMS requirements, NCCI edits, NCDs, LCDs, and payer specific edits required for clean claim submission.
• Assist in the design and implementation of workflow changes to reduce coding and billing errors.
• Collaborate on summarizing findings for provider documentation optimization opportunities.

What We're Looking For

• Associate Degree in a work-related discipline/field or equivalent combination of education and work experience.
• Five years of experience; must be proficient in coding surgical encounter specialties.
• Current role-related certification: RHIA, RHIT, CCS, CCS-P, CPC, COC, or CIRCC for advanced Interventional Radiology/ Cardiology coding.
• Successful completion of the Coder Proficiency Exam (pre-hire).
• Ability to consistently meet department’s quality and productivity standards.
• Knowledge of APC grouping methodology and health information systems (Epic and 3M 360e Computer Assisted Coding).
• Knowledge of NCCI and other CMS compliance issues, as well as standards and regulations pertaining to medical records.
• Ability to utilize ICD-10-CM/PCS and CPT-4 coding conventions, abstract information from records, and read medical documentation.
• Strong ability to develop and maintain supportive relationships with Physicians and clinical professionals.
• Ability to adapt to change, plan, organize, prioritize, work independently, and meet deadlines.
• Ability to solve technical and non-technical problems, foster effective relationships, and work with individuals at all levels.

Technical Stack

• Epic
• 3M 360e Computer Assisted Coding
• ICD-10-CM/PCS
• CPT-4

Team & Environment

You will interact with other teams and departments across the organization such as Patient Financial Services, the Patient Billing Office, the Revenue Integrity (Charge Master) Team, provider teams, and Compliance.

Benefits & Compensation

• Hourly rate generally starting at $60.15 - $67.75 per hour.

Work Mode

This is a fully remote position.

Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment.