Certified Coder

About the role

Review and validate diagnosis and procedure codes to ensure accuracy, compliance, and appropriate reimbursement. Audit patient encounters across departments for completeness and coding accuracy before claims submission. Verify ICD, CPT, and HCPCS code assignments using coding guidelines, reference materials, and industry best practices. Review provider documentation and clinical records to ensure coding supports services rendered and quality measures. Claims Processing & Revenue Integrity Post claims from the Electronic Health Record (EHR) and correct coding discrepancies as needed. Research, correct, and rebill rejected or unbilled charges to support timely reimbursement. Utilize payer guidelines and reimbursement knowledge to maximize claim accuracy and revenue capture. Ensure authorizations, modifiers, units, and specialty billing requirements are coded correctly. Provider & Team Collaboration Partner with providers, nurses, and health center staff to clarify documentation and coding questions. Request and obtain missing information necessary to complete the billing process. Serve as a coding resource and provide guidance on coding standards and best practices. Quality Assurance & Compliance Monitor coding quality and report questionable coding practices or charge entries to leadership. Maintain current knowledge of coding regulations, payer requirements, and industry updates. Meet established daily, weekly, and monthly productivity and accuracy standards.

Requirements

• High School diploma or GED and completion of a medical coding program
• 1-3 years’ experience in medical coding or billing field preferred
• Proficient in medical terminology
• Third party payer knowledge gained through experience or education required
• Working knowledge of medical billing systems like Medicare, Medicaid, EMR, etc.

Qualifications

• Certified Professional Coder with AAPC (American Academy of Professional Coders) or AHIMA (American Health Information Management Association)

Skills

• Medical Terminology
• Third Party Payer Knowledge
• Medical Billing Systems (Medicare, Medicaid, EMR)
• Coding Guidelines
• Industry Best Practices
• Claims Processing
• Revenue Integrity
• Provider Documentation
• Quality Assurance
• Compliance Monitoring

Benefits

• Generous Time Off
• Holidays
• Wellness Perks
• Retirement Planning
• Comprehensive Insurance Plans
• Employee Assistance Program (EAP)

Pay

TBD

Schedule

TBD