Certified Professional Coder

Key Responsibilities

• Analyze patient charts, physician notes and discharge summaries
• Ensure documentation is complete and accurate before coding
• Translate diagnoses and procedures into standardized codes using: ICD-10-CM (diagnoses), CPT (procedures), HCPCS (supplies/services)
• Make sure codes correctly represent services provided
• Follow healthcare laws and regulations (HIPAA, Medicare/Medicaid guidelines)
• Work with billing teams to submit coded claims to insurance companies
• Verify claim accuracy to ensure proper reimbursement
• Fix rejected or denied claims by reviewing and correcting codes
• Communicate with healthcare providers and insurance companies
• Protect sensitive patient information
• Follow strict privacy and data security standards
• Clarify documentation with physicians when needed
• Collaborate with billing and administrative teams
• Regularly update knowledge of coding systems and regulations
• Maintain certification through continuing education
• Perform coding audits and compliance reviews
• Train new coders or staff
• Specialize in areas like inpatient, outpatient, or specialty coding
• All other duties as assigned.

Company Policies

• Prevent coding errors that could lead to claim denials or audits
• Stay updated on coding changes and updates
• Communicate effectively with clinic/administrative personnel, assigned coder and CLT-Team
• Completes assigned training and education

Minimum Requirements

• High School diploma or GED equivalent
• Medical billing and coding training program - Certificate or associate degree
• Demonstrates experience with medical billing, CPT and ICD-10 codes, Revenue Cycle
• Ability to exercise discretion on sensitive and confidential matters
• Demonstrate ability to communicate effectively on the phone, in writing and via email
• Demonstrate computer skills with data entry software, Microsoft Word, and Excel
• Institutional accreditation and degree obtainment will be verified upon hire
• Knowledge of medical terminology, anatomy, and healthcare regulations
• Insurance, banking, hospital medical office or other experience with extensive customer service contact
• One or more years of billing and coding experience in medical field- required in the medical field.