MEDICAL CODER

Axis Community Health•Pleasanton, CA

35d•Onsite

About The Position

The Medical Coder is responsible for reviewing, coding, and processing medical, dental, and behavioral health encounters to ensure accurate and compliant documentation, coding, and billing specific to a Federally Qualified Health Center (FQHC). This role assigns appropriate ICD-10, CPT, and HCPCS Level II codes in accordance with federal, state, and payer-specific guidelines, including FQHC billing rules. The Medical Coder also resolves coding-related denials, supports timely reimbursement, and helps maintain compliance with Medi-Cal, Medicare, HRSA, and commercial insurance requirements. This position may assist with staff training, process improvements, and collaboration across billing, compliance, and clinical teams to ensure accurate encounter data and strengthen revenue cycle operations.

Requirements

High school diploma or equivalent; Associates degree in Health Information Technology or related field preferred.
Minimum two years of outpatient medical coding experience, preferably in a community health center, FQHC, or similar ambulatory care setting.
Current coding certification from CPC, CCA, CCS, RHIT, or RHIA.
Strong knowledge of ICD-10, CPT, HCPCS Level II, and outpatient coding guideline.
Familiarity with FQHC specific coding and billing, including PPS, wrap/PPS add-on, and documentation requirements.
Proficiency in reviewing clinical documentation for accuracy and completeness.
Ability to analyze and resolve coding-related denials.
Advanced knowledge of FQHC coding standards, encounter-based reimbursement models, and HRSA/UDS reporting requirements.
Experience processing specialty billing for chiropractic, acupuncture, podiatry, cardiology, and others.
Knowledge of outside entity account reconciliation.
Ability to retrieve patient information, input information, and locate information and resources.
Excellent time management skills to meet goals and objectives and the ability to be at work regularly and on time.
Strong analytical, employee relations, and interpersonal skills.
Excellent writing, business communication, editing, and proofreading skills.
Ability to interact effectively, professionally, and in a supportive manner with persons of all backgrounds.
Proactive, self-motivated and able to work independently as well as on a team with the ability to exercise sound independent judgment.
Ability to maintain a high level of confidentiality and a professional demeanor and must positively represent the organization at all times.
Must be able to adjust priorities quickly as circumstances dictate.
Must be a dynamic self-starter with demonstrated ability to work independently or in a group setting.
A can-do attitude, attention to detail, ability to organize and set priorities, with ability to multi-task effectively.
Ability to type a minimum of 35 WPM with minimal errors.
Must have good computer skills using Microsoft Office and the ability to use Axis departmental systems.
Must be able to use office equipment (i.e. copier, fax, etc.).

Nice To Haves

Knowledge of EPIC EPM/EHR is highly desirable.
Wisdom dental software knowledge is a plus.

Responsibilities

Review and assign accurate ICD-10, CPT, and HCPCS codes for medical, dental, and behavioral health encounters.
Ensure all coding complies with federal, state, Medicaid/Medi-Cal, Medicare, commercial payer, and FQHC-specific billing guidelines.
Verify that provider documentation supports the codes billed and request clarifications when needed.
Review and correct encounter data prior to claim submission to reduce errors and delays.
Work closely with providers to improve documentation accuracy and coding completeness.
Analyze and resolve coding-related denials rejections; submit corrected claims as needed.
Support the billing team with research on payer guidelines and policy updates.
Maintain proficiency in UDS reporting requirements and ensure accurate coding for quality metrics.
Collaborate with senior management to ensure adherence to HRSA, PPS, and encounter documentation standards.
Conduct internal chart audits as assigned to verify coding accuracy and identify training needs.
Assist in training clinical and billing staff on coding updates, documentation requirements, and best practices.
Stay current on changes in coding regulations, payer updates, E/M guidelines, and FQHC billing requirements.
Collaborate with the CFO and Billing Manager to enhance workflows aimed at improving overall efficiency and effectiveness of the billing department.
Participate in staff meetings, and attend other meetings and training events as assigned.
May be required to perform other related duties, responsibilities, and special projects as assigned.

Benefits

Employer paid health, dental, and vision benefits to the employee.
Option to participate in a 403(B) retirement plan with employer matching contribution.
Partial educational reimbursement.
12 paid holidays.
Accrued paid time off with each pay period.
Employee discount programs.

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