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Coding Integrity Specialist Jobs in Ohio (NOW HIRING)

University Hospitals

CDI II

Shaker Heights, OH

$33.50 - $45/hr

... integrity, coding and billing needs * Amendment for Outpatient Clinical Documentation Specialist • Performs review of facility outpatient encounters identified as potentially missing charges and ...

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Trice Healthcare

Coding Payment Resolution Spec

Kings Mills, OH · On-site

$17.50 - $22.50/hr

Coding Payment Resolution Specialist Responsible for reviewing all post-billed denials (inclusive ... Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring ...

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Coding Integrity Specialist information

What is a coding integrity specialist?

Coding Integrity Specialists are professionals who ensure the accuracy and compliance of medical coding within healthcare organizations. They review clinical documentation and coding processes to make sure that diagnoses, procedures, and services are coded correctly according to regulatory requirements and industry standards. Their work helps organizations receive appropriate reimbursement, avoid coding errors, and maintain compliance with healthcare laws. Coding Integrity Specialists often collaborate with medical coders, auditors, and healthcare providers to resolve discrepancies and provide education on best practices.

How does a coding integrity specialist typically collaborate with clinical staff and other departments?

Coding Integrity Specialists frequently work closely with clinical staff, billing teams, and compliance departments to ensure accurate medical coding and adherence to regulatory guidelines. They often clarify documentation with healthcare providers, participate in cross-departmental meetings, and provide education on coding best practices. This collaborative approach helps reduce errors, prevent claim denials, and maintain high standards for data integrity across the organization.

What are the key skills and qualifications needed to thrive as a coding integrity specialist, and why are they important?

To thrive as a Coding Integrity Specialist, you need comprehensive knowledge of medical coding systems (such as ICD-10, CPT, and HCPCS), healthcare regulations, and typically a certification like CCS or CPC. Proficiency with coding auditing software, electronic health record (EHR) systems, and compliance tools is essential. Attention to detail, analytical thinking, and strong communication skills are crucial soft skills for ensuring accuracy and collaborating with healthcare teams. These skills ensure accurate coding, regulatory compliance, and optimized reimbursement for healthcare organizations.

What is the difference between Coding Integrity Specialist vs Medical Coder?

AspectCoding Integrity SpecialistMedical Coder
CertificationsAHIMA or AAPC coding credentials, compliance trainingAHIMA or AAPC coding credentials, certification often preferred
Work EnvironmentHealthcare organizations, compliance departmentsHospitals, clinics, billing companies
Job FocusEnsuring coding accuracy, compliance, auditingAssigning medical codes for billing and documentation

The Coding Integrity Specialist and Medical Coder roles both require coding certifications and work within healthcare settings. However, the Coding Integrity Specialist primarily focuses on auditing, compliance, and maintaining coding accuracy, while Medical Coders are responsible for assigning codes for billing purposes. The Specialist role emphasizes oversight and integrity, whereas the Coder role centers on code assignment.

What are popular job titles related to Coding Integrity Specialist jobs in Ohio?

For Coding Integrity Specialist jobs in Ohio, the most frequently searched job titles are:

What job categories do people searching Coding Integrity Specialist jobs in Ohio look for?

The top searched job categories for Coding Integrity Specialist jobs in Ohio are:

What cities in Ohio are hiring for Coding Integrity Specialist jobs?

Cities in Ohio with the most Coding Integrity Specialist job openings:

Coding Integrity Specialist jobs near you
Infographic showing various Coding Integrity Specialist job openings in Ohio as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 16% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution.

HIS - Professional Coding Integrity Specialist (PRN)

Findlay, OH • On-site

Blanchard Valley Health System
Health Care and Social Assistance • 1 - 5K employees

5.8

Company rating: 5.8 out of 10

Based on 59 frontline employees who took The Breakroom Quiz

780th of 894 rated healthcare providers

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Recommended by students

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Posted 14 days ago

Job description

PURPOSE OF THIS POSITION
The primary purpose of the Professional Coding Integrity Specialist (PCIS) is to review, enter and/or modify charges as appropriate, including review of clinical documentation to ensure charge is supported and/or to determine specific charge/modifier assignments, for designated clinical areas.
JOB DUTIES/RESPONSIBILITIES
Duty 1: Review, enter and/or modify charge on encounters to ensure accurate and compliant and optimal charge capture in a time-sensitive manner for designated clinical service lines. Review clinical documentation to ensure charge is appropriately supported and/or to determine the assignment of the accurate charge, modifier, E&M levels, etc. Assign ICD-10 diagnosis codes as appropriate. Work "exception" accounts (e.g. canceled accounts, combined, unique modifier or charge rules requiring review, etc.) through review of clinical documentation and/or collaboration with appropriate resources, as needed, to resolve.
Duty 2: Support resolution of claim-scrubber edits (Quadax) resulting from charges entered by the Revenue Integrity Validation team; collaborate with clinical areas, coding, PFS, etc. to support resolution of edits; trend, identify opportunities, and collaborate with RI Educator and/or Claims Resolution Specialist to avoid/reduce future edits. Support Condition 44 notifications (inpatient to observation status) process by properly modifying charges and calculating hours etc.
Duty 3: Track and quantify revenue impact to organization as a result of charge corrections made, including impacts from modifications to processes.
Duty 4: Identify opportunities related to clinical documentation and/or other system enhancements to support optimal and accurate charge processes; collaborate with CDI Specialist, Claims Resolution Specialist, Revenue Integrity Auditor, Revenue Integrity Educator, clinical area, and other areas to support resolution of issues.
Duty 5. Demonstrate proficient knowledge of federal, state and third party charging guidelines of clinical areas supported by the Revenue Integrity Validation team to ensure optimal, accurate and compliant charging. Understand changes to applicable coding and billing regulations, including annual IPPS/OPPS revisions, by resourcing credible references (i.e. CMS website, Craneware, publications, professional contacts, reliable internet sources, seminars, etc.). Collaborate with clinical areas, Revenue Integrity Team, Coding Integrity Team and/or other impacted areas to support implementation of changes.
Duty 6: Participates in system testing as a result of upgrades, changes, enhancements, new application implementations, etc. that may impact Revenue Integrity Validation processes.
Duty 7: Regularly attends and actively participates in in-services, organizational and department meetings and continuing education programs as offered in order to remain current with organizational and industry changes and best practice. Communicate and disseminate information to other departments as applicable.
REQUIRED QUALIFICATIONS
  • An Associate's degree in a related field including, but not limited to, health information, business or related clinical profession preferred or 1-2 years' experience from which comparable knowledge and abilities have been acquired.
  • Coding certification (CCA or CPC) required or obtained with 9 months of hire date
  • Knowledge of medical terminology and anatomy and physiology required.
  • Knowledge of CPT/HCPCS/APC coding systems, appropriate use of applying modifiers, CPT Assistant, LCD/NCD and ICD-10 required.
  • Ability to research, review and interpret Federal, State and Local billing regulations required.
  • Familiarity with utilization of computers and commonly used applications, including Microsoft Office Suite, (Windows, Excel, Word, Outlook), electronic health record, internet required.
  • Ability to track and monitor data to identify trends pertaining to charge issues.
  • Excellent organizational, time management and problem-solving skills required; detail oriented and follow through.
  • Positive service-oriented interpersonal and communication (written and verbal) skills required.
PREFERRED QUALIFICATIONS
  • Other certifications applicable to primary clinical service line supported preferred.
  • Knowledge of regulatory compliance and reimbursement methodologies preferred.
  • Encoder experience preferred
  • Training and education skills preferred.

PHYSICAL DEMANDS
This position requires a full range of body motion with intermittent activities in walking, lifting, bending, squatting, climbing, kneeling, and twisting. The associate will be required to sit for five hours a day. The individual must be able to lift ten to twenty pounds and reach work above the shoulders. This position requires corrected vision and hearing in the normal range. The individual must have excellent eye-hand coordination and verbal communication skills to perform daily tasks.
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About Blanchard Valley Health System

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Blanchard Valley Health System, located in Findlay, OH, US, is a non-profit, integrated regional health system dedicated to providing a full continuum of health services to the residents of Hancock County and the contiguous communities in Ohio. The health system operates Blanchard Valley Hospital and Bluffton Hospital alongside a wide array of outpatient specialty clinics and centers such as the region's leading alcohol and drug addiction treatment center, Birchaven Village, a retirement community, and the Blanchard Valley Medical Practices. Founded in 1891, the health system's roots are ingrained in local philanthropy and community service.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

Findlay, OH, US

Year founded

1891

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