Certified Medical Coder

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Status:
Full-Time

Shift:
1st

Position Summary:
The Certified Medical Coder will play a crucial role in accurately coding and abstracting medical records for billing and reimbursement purposes. The Certified Medical Coder will be responsible for reviewing physician/non-physician documentation, accurately assigning CPT, ICD-10-CM and HCPCS Level II codes, and ensuring compliance with coding guidelines and regulations. Attention to detail, time management, and a high-level of customer service skills are required. We are looking for a positive team player with a strong work ethic and good attendance history. This full-time position reports to the Vice President-Claims Administration.
Position Qualifications:

Current Certification as a Certified Professional Coder (CPC*) form AAPC.
5+ years of coding experience preferred in Behavorial Health, Medication-Assited Treatment (MAT), and internal medicine settings.
Medicaid/Medi-Cal experience preferred.
High level of customer service skills is required.
Strong understanding of anatomy, physiology, and medical terminology required.
Ability to work independently and in a team environment.
Effective communication skills: both written and verbal.
Detail-oriented with high accuracy in coding and data entry.
Ability to maintain benchmarks such as production and low error rate.
AHIMA, RHIT, specialty coding certifications a plus.

Responsibilities:

Review and analyze medical records to identify and extract relevant diagnoses, procedures and services for accurate coding.
Assign appropriate diagnosis codes (ICD-10-CM) and procedure codes (CPT/HCPCS) based upon medical documentation.
Verify and ensure that all codes are accurately applied and comply with coding guidelines and regulations.
Review and resolve coding-related denials, discrepancies, and inquiries.
Assist physician/providers with questions regarding coding and documentation guidelines.
Provides ongoing feedback based on observations form coding physician/provider documentation.
Identifies opportunities for education and communicates trends to lead.
Review and resolve charge sessions that fail charge review edits, claim edits, and follow-up denials.
Work to improve billing based on findings/resolution of errors.
Manage assigned charge reviews, claim edits, and coding follow-up work queues.
Monitors charges and codes for appropriateness of modifiers in relation to NCCI/CCI edits and payer specific requirements.
Stay updated with the latest coding guidelines, regulations, and industry changes.
Maintain confidentiality and always adhere to HIPPA regulations.
Perform other duties and projects as assigned.

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