Medical Necessity Specialist - Outpatient Coder - (ON SITE)

Now Hiring: Medical Necessity Specialist

Join the Health Information Management Team at Cottage Hospital!

Are you detail-oriented, organized, and passionate about ensuring accurate medical coding and documentation? Cottage Hospital is seeking a Medical Necessity Specialist to support our Ancillary services, including lab and radiology, by ensuring proper coding, reducing documentation errors, and helping improve diagnostic accuracy across the organization.

If you’re looking for a role that blends healthcare, compliance, and provider education, apply today and help us strengthen the integrity of patient care and revenue cycle processes!

Job Summary:

The Medical Necessity Specialist plays a vital role in promoting accurate and compliant medical coding for Ancillary services. This position focuses on ensuring medical diagnoses support ordered procedures, identifying trends in documentation errors, and collaborating with providers to improve coding accuracy and reduce denied or written-off charges. The role also supports training initiatives under the guidance of the HIM Supervisor.

Key Duties & Responsibilities:

• Accurately code Ancillary services (lab and radiology) based on appropriate diagnoses

• Review medical orders to ensure alignment between services provided and diagnoses

• Investigate denied or written-off claims due to documentation errors

• Identify documentation trends and work with providers to implement corrective action

• Collaborate with internal and community providers to improve coding compliance

• Prepare and present coding quality reports to HIM leadership

• Support provider education and training related to diagnostic coding accuracy

• Recommend process improvements using data-driven insights