Coder

About the role

Heritage Health is seeking a full-time Coder to join our Pediatrics office team. This onsite position supports strong collaboration, real-time problem solving, and connection with the team. The Coder provides expertise in reviewing and assigning accurate medical codes for diagnoses, procedures, and services performed by physicians and other qualified healthcare providers. This position reports to the Director of Revenue Cycle.

Responsibilities

• Verify and code diagnosis, evaluation and management, procedures, or other codes required for completeness and accuracy of the record.
• Review electronic medical records initiated by a healthcare provider.
• Review and verify component parts of medical records to ensure completeness and accuracy of diagnosis, operations, and special therapeutic procedures.
• Code and/or review principal diagnosis, co-morbidities, complications, therapeutic and diagnostic procedures, supplies, materials, injections, and drugs using ICD-10, CPT, HCPCS, and any other required coding classification systems.
• Perform edit checks on data entered prior to transmittal and correct errors as indicated.
• Analyze medical record documentation for consistency and completeness for coding purposes using established criteria and regulations.
• Examine all documents in the record for authorized signature and patient identification to ensure sufficient documentation supports the diagnosis and treatment administered.
• Research and manage coding-related queries to clinical staff and provide guidance.
• Communicate findings and current coding, documentation, and billing updates to the Senior Compliance Specialist and direct leadership in a timely manner.
• Remain current on trends and changes in laws and regulations governing medical record coding and documentation.
• Demonstrate an understanding of confidentiality to protect the patient and the corporation.
• Participate actively in the Patient Centered Medical Home (PCMH) model of care as part of the Heritage Health PCMH Care Team.
• Perform other job-related duties as assigned.

Requirements

• High school graduate or equivalent.
• Associate’s degree in medical coding or related field preferred.
• Certified Professional Coder (CPC) credential required; AAPC preferred.
• One-year FQHC medical billing and/or coding experience preferred.

Skills

• Working knowledge of current CPT and ICD-10 codes and basic medical terminology.
• Proficiency in operating computers, calculators, copiers, printers, and telephones.
• Strong organizational skills with the ability to prioritize and be detail-oriented.
• Proficient in Microsoft Office, including Outlook, Word, and Excel.
• Excellent written and oral communication skills.
• Ability to compose queries in an understandable manner.
• Ability to perform in a fast-paced environment while remaining professional, courteous, and calm.
• Ability to understand and interpret policies and regulations.
• Demonstrates initiative to provide quality service and improve efficiency.
• Ability to establish and maintain positive working relations with coworkers.

Benefits

• Health Insurance: 100% employer-paid employee coverage for medical, dental, and vision plans for full-time employees.
• Life Insurance: Employer-paid, with optional coverage available for an additional cost.
• Disability Insurance: Short-term disability insurance based on age and salary; 100% employer-paid long-term disability insurance.
• Retirement: 403(b) plan with Heritage Health matching up to 4% of employee contributions.
• Paid Time Off: 120 hours Paid Time Off (PTO) in the first year, 56 hours Extended Illness Bank (EIB) in the first year, and 8 paid holidays for full-time employees (amounts are pro-rated for part-time employees who are 0.5 FTE or higher).
• Employee Assistance Program (EAP): Free telehealth visits for healthcare, counseling, and health and wellness coaching for all employees and their immediate household members.

Schedule

No weekends or holidays, ensuring a healthy work-life balance.