Improving community wellness through access to quality, affordable, integrated primary healthcare.
Certified Coder
Location
United States
Posted
3 days ago
Salary
0
Seniority
Senior
Job Description
Certified Coder
Primary Health Solutions
• Responsible for entering/auditing/coding patient services to ensure encounters transfer properly for submission to insurance payers. • Analyze coding related claim issues, process gaps and denials to trend feedback for providers by location and/or specialty. • Review provider documentation (including hospital procedures) and translate services into correct codes. • Append payer specific modifiers and claim criteria when applicable. • Review incomplete encounters and code based on available documentation in EHR systems. • Know and understand several different coding systems, including ICD-10-CM, ICD-10-PCS, CPT, Level 1 HCPCS and Level 2 HCPCS. • Use computers / billing software to create and bill encounters that generate clean claims. • Attend internal meetings relevant to EHR workflows and share best coding practices. • Assist Operations when coding guidance is requested for existing or new services. • Understand payer reimbursement and PPS visit qualification for Medicare and Medicaid. • Trend areas of focus where provider training or re-training is needed. • Monitor, trend and resolve tasks related to coding edits, rejections, and denials. • Communicate with providers, patients, and insurance payers. • Review patient accounts and correct any missing or inaccurate information. • Investigate and appeal claims that were denied incorrectly. • Complete coding projects such as quarterly or ad hoc provider chart audits. • Adapt to updates and changes in billing software. • Perform all other duties and tasks as assigned.
Job Requirements
- Knowledgeable and experienced with Medical Terminology.
- Multitask oriented, organizational and team skills.
- Proficiency with computers, Microsoft Office 360 (Outlook, Word & Excel), Adobe and medical billing software.
- Knowledge of unfair debt collection practices and insurance guidelines.
- Understanding of primary code classifications: ICD-10-CM, ICD-10-PCS, CPT and HCPCS.
- Communication skills with patients/healthcare companies.
- Basic accounting and bookkeeping practices.
- Certified Professional Coder (CPC) certificate with some medical billing experience.
- Ability to speak Spanish helpful.
Benefits
- Stricter patient confidentiality and information security
- Opportunities for training office staff on billing/coding updates
Related Guides
Related Categories
Related Job Pages
More Medical Billing and Coding Jobs
Medical Coder
TaraVista Behavioral Health CenterA regional behavioral health center caring for children, adolescents and adults
• You will code hospital and professional inpatient visits using the International Classification of Disease 10-Clinical Modification (ICD-10-CM) and Current Procedure Terminology (CPT) coding methodology in accordance with official coding and reimbursement guidelines • You will work under the general supervision and reporting to the Director of HIM • You are responsible for professional CPT coding for Medicare and Medicare like payers • You will abstract all data elements into the WellSky EMR platform • You will use the TruBridge encoder integration to review Medical Necessity edits and CCs, MCCs, coding order and DRG assignment • You will maintain current working knowledge with all coding rules, coding guidelines, Medicare, and Medicare like payer regulations in accordance with the hospital coding compliance policies and procedures
Supervisor, Certified Professional Coder
Tryon Medical PartnersStronger relationships. Better health.
• Provides direct supervision, mentorship, and daily operational oversight of the Lead Certified Professional Coder and coding staff • Supports staffing, scheduling, workload distribution, and productivity management • Assists with onboarding, training, coaching, and performance evaluations of coding staff • Promotes accountability, collaboration, and professional development within the team • Performs and oversees charge review to determine appropriate CPT and ICD-10 codes for physician services • Ensures compliance with CMS, regulatory, and third-party payer guidelines
Clinic Coder II-Primary Care
CommonSpirit HealthCommonSpirit Health is a nonprofit organization that is on a mission to improve people’s health while making “the healing presence of God known.” The orga
Role Description As a Coder, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently. - Accurately translate patients’ medical records into standardized codes for diagnoses and treatments. - Ensure compliance with legal, regulatory, and organizational standards. - Combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. - Maintain clear communication with providers and staff to ensure claims are processed correctly and on time. - Accurately abstract information from the medical records into the appropriate coding systems. - Determine the most appropriate diagnosis after a thorough review of the medical records. - Work closely with practice staff regarding coding and assignment of MS-DRGs (Diagnosis Related Group) and APCs (Ambulatory Payment Classification). - Code medical records using ICD-9-CM and CPT-4 coding rules and guidelines. - Ensure thorough and compliant coding to support patient records and submission of billing for payment. - Accurately sequence diagnostic and procedural codes according to organization specified procedures. - Provide codes to various departments upon request. - Enter and validate charges using appropriate tools and validate diagnoses with the medical documentation provided. - Compare charges on accounts with the procedures coded and identify any discrepancies. - Notify Coding Manager of any discrepancies and collaborate as needed to rectify the account. Qualifications - Certified Professional Coder, upon hire - Certified Professional Coder Hospital Apprentice, upon hire - Certified Professional Coder Apprentice, upon hire - Certified Coding Associate, upon hire - Cardiology Coding, upon hire - Certified Coding Specialist, upon hire - Certified Coding Specialist - Physician Based, upon hire - Certified Cardiovascular and Thoracic Surgery Coder, upon hire - Certified Health Care Compliance, upon hire - Certified Interventional Radiology Cardio Coder, upon hire - Certified Professional Coder Hospital, upon hire - Radiology Certified Coder, upon hire - Registered Health Information Administrator, upon hire - Registered Health Information Technician, upon hire Requirements - Prior Healthcare Billing Experience (Preferred)
Coding Supervisor
University of CaliforniaSince 1869, the University of California has been providing excellent college educational programs for students seeking bachelor's to doctoral degrees. The Univ
Coding Supervisor Location: Los Angeles, CA, USA Onsite or Remote Flexible Hybrid Work Schedule Monday - Friday, 8:00am - 5:00pm PST Salary Range: $65800 - 130800 Annually Employment Type 2 - Staff: Career Duration indefinite Job # 30719 Primary Duties and Responsibilities Press space or enter keys to toggle section visibility Under the direction of the Physician Billing Office (PBO) Coding Director, the Coding Department Supervisor oversees the daily operations of a team of certified coding professionals. This position is responsible for ensuring coding quality, productivity, compliance, and workflow standards are met while supporting staff development and operational effectiveness. The supervisor serves as a resource for coding guidance, system operations, regulatory compliance, and process improvement initiatives that support accurate and timely coding services. Key Responsibilities - Supervise and support a team of certified coding staff, including training, scheduling, coaching, and performance management. - Monitor coding productivity, quality, turnaround times, and work queue volumes to ensure departmental goals are achieved. - Oversee daily coding operations and assign work based on operational priorities and staffing needs. - Serve as a resource for coding staff, physicians, and clinical departments regarding coding questions and documentation requirements. - Conduct coding audits and quality reviews to ensure compliance with coding guidelines, billing regulations, and organizational policies. - Identify coding trends and performance issues and provide training and corrective action as needed. - Ensure compliance with HIPAA, federal regulations, payer requirements, and coding standards. - Develop and maintain coding procedures, training materials, and departmental resources. - Collaborate with leadership and cross-functional teams to improve workflows, resolve operational issues, and support process improvement initiatives. Salary Range: $65,800 - $130,800/Annually Job Qualifications Press space or enter keys to toggle section visibility All items listed below are required: - CPC (Certified Professional Coder – AAPC) - Bachelor’s degree in Health Information Management, healthcare administration, or related field, or equivalent experience - Five or more years of medical coding or health information management experience - Three or more years of supervisory experience in a healthcare or coding environment - Demonstrated knowledge of ICD-10, CPT, and HCPCS coding systems and guidelines - Demonstrated understanding of CMS, payer, and regulatory requirements for physician billing - Working knowledge of health information management operations in a clinical or hospital setting - Familiarity with HIPAA regulations and patient data privacy requirements - Experience with electronic health record systems (e.g., CareConnect/Epic) - Ability to analyze coding data, trends, and performance metrics using tools such as Excel or reporting systems - Strong interpersonal skills to collaborate with clinical, operational, and administrative teams - Proven ability to manage competing priorities and meet established deadlines - Effective written and verbal communication skills for training and operational guidance - Experience supporting audit processes and compliance programs - Ability to provide leadership and training Preferred: - CPMA (Certified Professional Medical Auditor), CHC (Certified in Healthcare Compliance), HCC (Risk Adjustment Coding Certification) or Specialty Certification - Familiarity with revenue cycle processes and billing operations Notes: Skills are subject to test. As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.


