Certified Coder I

Role Overview and Purpose

The Certified Medical Coder I is responsible for reviewing and accurately assigning diagnostic and procedural codes for medical services based on medical documentation, in compliance with official coding guidelines, payer requirements, and regulatory standards. This is an entry-level coding position suitable for professionals with certification and limited experience.

Responsibilities

• Review and abstract clinical documentation for accurate ICD-10-CM, CPT, and HCPCS Level II coding.
• Ensure coding is compliant with federal regulations (e.g., CMS), payer policies, and audit standards.
• Maintain quality and productivity standards as defined by department policies.
• Enter and verify codes within the EHR or coding software.
• Assist in minimizing claim denials and rejections due to coding issues.
• Work with providers and staff to clarify diagnoses and procedures as needed.
• Participate in coding audits and implement feedback.
• Maintain confidentiality of health records by HIPAA and organizational policies.
• Keep current with coding changes and continuing education requirements needed to maintain coding certification.

Education and Experience

• High school diploma or GED required
• Associate’s degree preferred
• Must have one of the following credentials:
  • Certified Professional Coder (CPC or CPC-A) – AAPC
  • Certified Coding Associate (CCA) – AHIMA
  • Certified Coding Specialist (CCS) – AHIMA
• 0-2 years of experience in medical coding required (may include CPC-A)
• Exposure to outpatient or professional fee coding
• Familiarity with insurance claim workflows and denial management

Additional Qualifications (Knowledge, Skills, and Abilities)

• Proficiency in medical terminology, anatomy & physiology, and coding systems
• Knowledge of EHR systems and coding platforms (e.g., eClinicalWorks, Codify, EncoderPro)
• Basic understanding of medical coding systems; ICD-10, CPT, HCPCS
• Detail-oriented with strong analytical and organizational skills
• Ability to work independently and collaboratively as a team member
• Effective communication skills
• Proficiency with computer systems and coding software/books

Physical Requirements

• Ability to lift/carry 10lbs weight
• Ability to stand for long periods of time

Pay

$27.21 to $38.09 per hour depending on experience.