Medical Coder
About The Position
The Medical Coder is responsible for day-to-day coding and billing operations for services billable under grants and federal, state, and county programs, including Medicare, Medicaid managed care, and private insurance. The position may be performed remotely after required onsite training. Candidates must reside in Washington State to participate in training and attend occasional in-person meetings as needed. The role reviews and adjudicates service coding from documentation, maintains procedure-code information for provider visits, and ensures diagnoses and procedures are accurately identified, sequenced, coded, and billed in accordance with applicable guidelines and policies. The Medical Coder also researches coding questions, consults providers when documentation is unclear or incomplete, tracks insufficiently documented cases, and supports accurate and ethical reimbursement.
Requirements
- High school graduate or equivalent.
- Two years of experience working in healthcare as a production coder.
- Certification as a Certified Professional Coder (CPC) by AAPC or Coding Specialist (CCS) certification by AHIMA.
- Proficiency in reading, speaking, understanding, and writing English.
- Effective oral and written communication skills.
- Professional and effective representation of the organization to the community.
- Ability to remain calm and effective in high-pressure and emergency situations.
- Ability to work with initiative and effectiveness in a fast-paced environment and produce high-quantity, high-quality work.
- Creative and resourceful problem-solving ability.
- Knowledge of medical terminology and HIPAA regulations and compliance.
- Ability to make decisions regarding sensitive information.
- Comprehensive knowledge and understanding of medical coding.
- Proficiency with Microsoft Office applications, including Word, Excel, and Outlook.
- Washington State residence is required to participate in onsite training and attend occasional in-person meetings.
Nice To Haves
- Bilingual skills.
- Familiarity with Federally Qualified Health Centers.
- Experience working in a not-for-profit organization.
- Experience working with low-income, multi-ethnic populations.
- Experience working with NextGen.
Responsibilities
- Review and adjudicate coding of services from documentation in a timely manner.
- Maintain physician/provider visit procedure codes and notes to identify appropriate ICD-10 and CPT codes for charge processing.
- Ensure diagnosis ICD-10 codes, procedure CPT codes, and HCPCS codes are identified, sequenced, and coded accurately and ethically for optimized reimbursement.
- Assign Evaluation and Management codes and key concepts/elements documented in patient notes, using applicable professional and technical coding guidelines.
- Research correct codes for routine, new, or unusual diagnoses and procedures not clearly listed in ICD-10 and CPT guidelines.
- Identify procedures that may require modifiers, including 340B, for billing and reporting.
- Consult providers for clarification when clinical data is conflicting or ambiguous, or significant documentation is missing.
- Track cases with insufficient documentation and ensure they are appropriately coded and billed.
- Ensure documentation adheres to federal, state, and county billing policies.
- Adhere to attendance standards to support daily operations and continuity of patient care.
Benefits
- Health insurance, including medical, dental, and vision coverage.
- Up to 120 hours of vacation time every 12 months, prorated by FTE.
- Paid sick leave.
- 10 paid holidays.
- 403(b) Safe Harbor retirement plan with employer match.
- Disability insurance.
- Life insurance.
- $0.75 per hour for employees who demonstrate proficiency in a second language.
- Comprehensive benefits package addressing health, time off, retirement, and career advancement needs.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
