Certified Coding Specialist
TalentPath Group
 Cincinnati, OH

POSITION: Certified Coding Specialist

LOCATION: Cincinnati, OH



Company is seeking a Coding Specialist whose primary responsibility is thorough review of managed care contracts and comparison of such contracts against healthcare claims to identify underpayments for the assigned client.


  • Have one or more of the following certifications: Certified Coding Specialist (CCS), Registered Health Information Analyst (RHIA), Registered Health Information Technician (RHIT)
  • 2+ years of experience working with hospital claims
  • Experience with healthcare codes including CPT, HCPCS, ICD-9, ICD-10, DRG
  • Local or close enough for a short easy move


  • Researches, communicates, and educates others on coding changes that impact reimbursement
  • Identifies areas of opportunity that occur as a result of a coding or billing error
  • Reviews insurance contracts to gain thorough understanding of payment methodologies
  • Examines claims and calculates reimbursement based on contract terms to determine accuracy of payment through use of various reports and supporting documentation
  • Contacts insurance company to obtain missing information, explain and resolve underpayments, and arrange for payment or adjustment processing on behalf of client
  • Prepares and submits correspondence such as letters, emails, faxes, online inquiries, appeals, adjustments, reports, and presentations
  • Maintains regular contact with necessary parties regarding claims status including payors, clients, managers and other personnel
  • Supports and directs claims to all departments and client onsite analysts
  • Builds strong, lasting relationships with clients, payors, and personnel
  • Attends client, department, and Company meetings
  • Complies with federal and state laws, Company and department policies and procedures


  • Minimum 2-years of experience working with hospital claims in some capacity
  • Familiarity with hospital billing guidelines and requirements
  • Knowledge of healthcare codes including CPT, HCPCS, ICD-9, ICD-10, DRG and ability to correctly use and apply codes in an operational setting
  • Ability to read and interpret an extensive variety of documents such as contracts, claims, medical records, EOB's, policies and procedures in written (English), and diagram form
  • Familiarity with CDM and its impact on reimbursement
  • High School diploma or equivalent though college degree is preferable
  • Ability to define problems, collect data, establish facts, and draw valid conclusions
  • Strong organization and time-management skills
  • Moderate computer proficiency including working knowledge of MS Excel, Word, and Outlook
  • Ability to mathematically calculate rates
  • Strong customer service orientation with superb communication skills
  • Strong team player
  • Commitment to Company values


Competitive salary and benefits commensurate with experience and qualifications.


For immediate consideration, please send us your current resume.