Coding Specialist
About this role
About Our Company:
At Infinx, we're a fast-growing company focused on delivering innovative technology solutions to meet our clients' needs. We partner with healthcare providers to leverage automation and intelligence, overcoming revenue cycle challenges and improving reimbursements for patient care. Our clients include physician groups, hospitals, pharmacies, and dental groups.
We're looking for experienced associates and partners with expertise in areas that align with our clients' needs. We value individuals who are passionate about helping others, solving challenges, and improving patient care while maximizing revenue. Diversity and inclusivity are central to our values, fostering a workplace where everyone feels valued and heard.
A 2025 Great Place to Work®
In 2025, Infinx was certified as a Great Place to Work® in both the U.S. and India, underscoring our commitment to fostering a high-trust, high-performance workplace culture. This marks the fourth consecutive year that Infinx India has achieved certification and the first time the company has earned recognition in the U.S.
Summary Description:
The Medical Coder assigns accurate diagnosis and procedure codes for inpatient, outpatient, and ambulatory encounters including clinic visits, ambulatory surgery, observation, emergency department, and ancillary services. This role requires expert command of ICD-10-CM, CPT, HCPCS, and modifier usage as well as strict adherence to official coding guidelines and payer policy.
This role operates in a high-volume, metrics-oriented outsourced environment with client-specific accuracy and productivity targets.The Coding Specialist also resolves coding-related claim rejections and denials, supports documentation improvement, and maintains current working knowledge of payer policy and regulatory change.
Location: Remote
Responsibilities:
- Assign accurate ICD-10-CM diagnosis codes and CPT/HCPCS procedure codes for ambulatory encounters in accordance with official coding guidelines, AMA CPT guidance, and payer-specific policy
- Apply correct modifiers (including 25, 26, 27, 50, 59, XE/XP/XS/XU, LT/RT, and global period modifiers) to support accurate reimbursement and pass NCCI and global edits
- Code across ambulatory settings including clinic E&M, ambulatory surgery, observation, emergency department, infusion/injection, diagnostic imaging, and ancillary services are assigned
- Review clinical documentation to confirm medical necessity and support code selection; submit compliant, non-leading physician queries when documentation is unclear, incomplete, or contradictory
- Apply correct sequencing of primary and secondary diagnoses and link diagnoses appropriately to procedures
- Identify and report charge capture errors, missing charges, and documentation deficiencies to the appropriate upstream owner
- Maintain coding accuracy at or above the client-defined threshold (typically 95%) and meet daily productivity targets (charts or encounters per hour, or RVU-based as defined by client)
- Document coding rationale and query activity clearly in the encoder, EHR, or coding workflow tool
- Resolve coding-related claim rejections and denials by reviewing payer responses, applying corrected codes or modifiers, providing supporting documentation, and following claims through to resolution
- Maintain current working knowledge of best coding practices, payer policy, and regulatory changes by accessing NCD, LCD, and coding policy resources and participating in continuing education
- Stay current with annual ICD-10-CM, CPT, and HCPCS code set updates, and MPFS final rules, and payer policy changes
- Maintain full compliance with HIPAA, CMS regulations, and fraud/abuse regulations including the False Claims Act
- Assignments may shift across ambulatory specialty areas based on client needs and individual strengths within the scope of the role
- High School Diploma or GED
- 1+ years of medical coding experience
- Multi-specialty coding experience (e.g., surgery, cardiology, GI, orthopedics, oncology, primary care) preferred
- Experience with split/shared visit, incident-to, and time-based E&M coding under current CMS guidelines preferred
- Prior experience supporting coding audits, formal appeals authoring, or external payer audit response preferred
- Current coding certification through AAPC (CPC, COC) or AHIMA (CCS, CCS-P, RHIA, RHIT) preferred
- Expert command of ICD-10-CM, CPT, HCPCS, and modifier rules
- Familiarity with NCCI edits, MUE edits, global edits, and LCD/NCD policies
- Proficiency with encoder tools (3M, TruCode, Optum EncoderPro, or comparable) and EHR, PMS systems
- Strong understanding of clinical documentation and ability to draft compliant, non-leading physician queries
- Excellent attention to detail and ability to maintain accuracy under productivity pressure
- Ability to establish and maintain effective working relationships with team members, supervisors, managers, clients, and providers
- Ability to prioritize workload and manage multiple responsibilities in a highly organized, efficient, and effective manner
- Knowledge of HIPAA, billing compliance, CMS regulations, and fraud/abuse regulations
Joining Infinx comes with an array of benefits, flexible work hours when possible, and a genuine sense of belonging to a dynamic and growing organization.
- Access to a 401(k) Retirement Savings Plan
- Comprehensive Medical, Dental, and Vision Coverage
- Paid Time Off
- Paid Holidays
- Additional benefits, including Pet Care Coverage, Employee Assistance Program (EAP), and discounted services
Originally posted on Himalayas