Medical Coder Pre Claims

Baylor Genetics

16d•Hybrid

About The Position

The Medical Coder, RCM is responsible for ensuring coding accuracy and claim readiness prior to submission, with a focus on resolving missing or invalid order and documentation elements that drive rejections, denials, and delayed reimbursement. This role partners closely with RCM front-end teams and the broader RCM organization to strengthen clinical defensibility and coding integrity through standardized workflows, proactive quality reviews, and documentation readiness. What this role exists to do Strengthen pre-claim coding and documentation integrity to reduce avoidable rework and improve reimbursement outcomes. Who it impacts Patients, providers, Client Services, Market Access partners, and Revenue Cycle operations benefit from improved claim quality and fewer downstream delays. What success looks like Improved front-end completeness (e.g., fewer missing ICD-10, demographic, or insurance elements), improved clean-claim readiness, and fewer coding- or documentation-related denials.

Requirements

High school diploma or equivalent; additional education in health sciences or a related field preferred.
Demonstrated working knowledge of ICD-10-CM and CPT/HCPCS coding concepts as applied to claim-submission readiness.
Proven ability to identify missing or invalid claim-critical data elements and drive resolution through cross-functional coordination.

Nice To Haves

Professional coding certification (AAPC/AHIMA or equivalent).
Experience supporting pre‑claim quality, audits, or denial prevention workflows in a high-volume healthcare revenue cycle environment.