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Medical Coding Specialist
Full Time
St. Louis, MO, US
Join Us to Build Healing and Hope Together!
As leaders in children's mental health and wellness, St. Louis Children's and KVC Health Systems Youth Mental Health Care have partnered to create one of the nation's most innovative and transformative youth mental health and wellness campuses. The partnership includes a 77-bed acute care hospital and outpatient programs. Located on the KVC Missouri Children's Mental Wellness Campus conveniently located in Webster Groves, Missouri, the peaceful environment and broad continuum of care allow children and families to access the appropriate level of treatment throughout their healing experience. The new campus is slated to open in late 2026. Learn more at stlouischildrenskvc.org. Join us and be a part of this journey of healing and hope for thousands of children and teens.
Job Summary
The Medical Coding Specialist is KVC's Hospitals subject matter expert on medical coding. They are responsible for ensuring maximum billing opportunities for KVC Hospitals, Inc. They will conduct audits and code reviews on all documentation of medical providers to ensure accuracy and optimum billing recoupment is met for KVC Hospitals. This role will collaborate with the medical providers, Utilization Review Department, and Accounts Receivable Department to ensure all legal requirements regarding coding procedures and practices are met and billing can be maximized in the most time efficient manner. The Medical Coder will support and foster a culture that is focused on integration of utilization review, risk management, and quality assurance into management in order to ensure the judicious use of the facility's resources and high-quality care.
Education:
Minimum of a high school diploma or equivalentfrom an accredited institution.Bachelor's degree in Health/Hospital Administration, Business Administration or related human services field preferred.
Licensure/Certification:
One of the following certifications is required: Certified Coding Associate Credential (CCA), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Medical Coder (CMC), and Certified Inpatient Coder (CIC). Valid driver's license and auto insurance required.
Experience:
Minimum of four (4) to seven (7) years of medical coding experience. Experience working in hospital or healthcare field with specific role in medical coding.
Preferred Experience/Skills:
Five (5) or more years related experience in behavioral health/psychiatric medical coding field. Preferred medical coding certification prior to hire date. Requires skills in MicrosoftOffice Suite, including Word, Excel, Outlook email and experience working within an Electronic Health Record.
Major Duties:
Practice conduct that displays respect for all KVC colleagues and community stakeholders regardless of age, gender
identity, sexual orientation, race, religion, veteran status or ethnicity.
• Serve as resource and subject matter expert to ensure correct medical coding.
• Classifies medical/psychiatric data from patient records and is responsible for translating diagnostic and clinical information into the maximized billing alpha-numeric ICD-10 codes.
• Provide training and education of medical providers and treatment team in the functions of coding and enhancement of current practices.
• Ensure Utilization Review and billing services are following professional standards, state and federal regulatory requirements and licensing bodies.
• Maintain current knowledge of KVC's operating systems including, but not limited to, EHR and HRIS tools.
• Maintain current knowledge of JIAC and KVC policies and procedures, KVC programs and services, and outside community agencies.
• Completes all necessary tracking and reporting on statistical data for analysis utilization review data, including but not limited to tracking and reporting out trends, admission insurance breakdowns, daily reports, etc.
• Ensures KVC Hospitals achieves clinical outcomes through fiscal accountability.
• Maintains strictest confidentiality about patient and patient'sfamily information.
• Collaborates with the Utilization Review Department and Accounts Receivable Department to monitor collection efforts and work to resolve disputesto expediate payment and reduce denials and bad dept levels.
• Works on a multi-departmental team to ensure maximization of insurance recoupment through best practices in medical coding and to assist in successful achievement of KVC Hospitals' fiscal goals.
• Communicates effectively and respectfully both orally and in writing with internal staff and external payor sources; as well, uses strong active listening skills.
• Participates in other internal committees as directed (Medical Management/Executive Committee, Performance
Improvement (PI) Committee) and others as assigned.
• Some day and overnight travel will be required to meet with KVC Hospitals treatment teams in other locations.
Physical Requirements
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to stand, walk, talk, or hear, and taste or smell. The employee frequently is required to use hands to finger, handle, or feel; reach with hands and arms; climb or balance; and stoop, kneel, crouch, or crawl. The employee is occasionally required to sit for intermittent amounts of time. The employee must regularly lift and/or move up to 10 pounds, frequently lift and/or move up to 25 pounds, and occasionally lift and/or move up to 75 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Benefits & More
Employee benefits and culture fall under the KVC Health Systems umbrella. KVC is a family of private, nonprofit organizations that strengthen families, prevent child abuse and neglect, and help people achieve mental health wellness. Through our broad continuum of care, we are proud to be a national leader in mental health, child welfare, and health and human services transformation.
At KVC, we offer a positive, supportive workplace where each person can do work they love. In fact, we're so proud of our culture that we see it as our top competitive advantage in the health and human services field. Based on the voice of our employees, KVC has an incredible 83 Work Wellbeing score on Indeed, a rating so high and rare that it places KVC among the top 1% of employers nationally. KVC was also named #15 on Glassdoor's Best-Led Companies 2025 list, a recognition achieved entirely based on anonymous employee reviews. In addition to being mission-driven, we offer employees an unparalleled level of flexibility, wellbeing, learning, inclusion, recognition, and rewards.