Medical Billing Coder I (69287)

VARIETY CARE INC•Oklahoma City, OK

3d•Onsite

About The Position

The Medical Billing Coder I is responsible for reviewing, analyzing, and coding patient medical documentation to support accurate billing, reimbursement, and regulatory compliance. This position translates clinical documentation into standardized medical codes and ensures claims are complete, accurate, and supported by appropriate documentation prior to submission. The Medical Billing Coder I plays a critical role in reducing claim denials, supporting revenue cycle performance, and ensuring patients are billed appropriately according to payer and government guidelines. This role collaborates with providers, claim resolution specialists, insurance representatives, and clinic staff to resolve coding issues, improve documentation quality, and support timely reimbursement.

Requirements

High school diploma or GED equivalent required
Minimum one (1) year of experience in medical billing, coding, accounts receivable, denial resolution, or related healthcare revenue cycle functions
Experience reviewing EOBs, resolving denial issues, or working with CPT coding preferred
Experience interacting and communicating effectively with providers and staff in a professional healthcare environment
CPC-A certification required within two (2) years of employment
Experience using EMR/EHR systems required; EPIC experience preferred
Proficiency with Microsoft Office applications
Experience navigating insurance web portals
Accurate typing and data entry skills
Basic knowledge of ICD-10-CM, CPT, HCPCS, medical terminology, anatomy, and payer guidelines
Prolonged sitting and computer use
Frequent keyboarding and repetitive hand motions
Frequent visual concentration and attention to detail
Ability to maintain concentration in a fast-paced environment
Ability to communicate effectively verbally and in writing

Nice To Haves

Prior coding experience in Medicare, Medicaid, commercial, private, or OB specialties
Experience working in Federally Qualified Health Centers (FQHCs) or healthcare clinic environments
Additional coding certifications preferred

Responsibilities

Review assigned claims to ensure accurate coding and claim submission prior to billing.
Analyze provider documentation, clinical notes, and electronic medical records to assign appropriate ICD-10-CM, CPT, and HCPCS codes.
Abstract and compile provider documentation, coding information, and claim data necessary for reimbursement.
Ensure assigned codes accurately reflect services rendered and support medical necessity requirements.
Review claims for missing, incomplete, vague, or inconsistent documentation and obtain clarification as needed.
Complete coding corrections, billing adjustments, rebill requests, and claim updates as necessary.
Sequence codes according to payer, government, and organizational requirements.
Review denied or rejected claims to determine root cause and identify corrective actions.
Research payer requirements and communicate with insurance representatives regarding claim denials and reimbursement issues.
Request and upload required documentation to patient accounts and payer systems.
Validate payer information and verify patient eligibility when applicable.
Identify documentation deficiencies and communicate concerns to providers and applicable staff.
Monitor coding edits, payer trends, and denial patterns to support process improvement efforts.
Share coding trends, denial patterns, and process improvement opportunities with leadership and team members.
Support development of workflow improvements, SOPs, visual aids, and coding process enhancements.
Collaborate with Claim Resolution Specialists, providers, clinic staff, and leadership to resolve coding and reimbursement issues.
Mentor and support Claim Resolution Specialists by helping improve information gathered upfront to reduce denials.
Communicate professionally and effectively with providers, coworkers, patients, insurance representatives, and external partners.
Answer provider questions accurately and provide constructive feedback to improve documentation quality.
Maintain compliance with HIPAA, Medicare, Medicaid, commercial payer requirements, and organizational policies.
Maintain current knowledge of coding guidelines, payer requirements, regulatory updates, and reimbursement practices.
Ensure proper filing, handling, and confidentiality of protected health information (PHI).
Follow all company policies, procedures, and departmental standards.
Meet established productivity, quality, and timeliness standards.
Demonstrate professionalism, adaptability, accountability, and sound judgment.
Participate in department meetings, training, and special projects as assigned.
Perform other duties as assigned.