Medical Records Coder

County of Contra Costa•Martinez, CA

15h•Onsite

About The Position

The Contra Costa Health Department is offering an excellent career opportunity for qualified individuals interested in the Medical Records Coder position. There is currently one (1) vacancy in the Contra Costa Health Plan (CCHP) Claims Unit in Martinez, CA. CCHP is a federally qualified, state-licensed, and county-sponsored Health Maintenance Organization (HMO) serving Contra Costa County in the East Bay of the San Francisco Bay Area. Established in 1973, CCHP was the first county-sponsored HMO in the United States and today serves as the largest managed care health plan in Contra Costa County, covering more than 250,000 residents. CCHP is committed to providing equitable, accessible, and high-quality healthcare to our culturally and linguistically diverse members. The Medical Records Coder is responsible for ensuring accurate coding, auditing, validation, and adjudication of medical claims. This position plays a critical role in maintaining claims payment accuracy, supporting system integrity, and ensuring compliance with state and federal regulations. We are looking for someone who is: Detail Oriented. You will be responsible for accurately coding and abstracting sensitive information A strong communicator. You must communicate effectively verbally and in writing A team player. You will be expected to work both independently and as part of a team Dependable. You will be responsible for day-to-day assignments, staying updated about all regulation changes, and participating in on-going training

Requirements

Possess and maintain a valid Certified Coding Specialist (CCS) or Certified Coding Specialist - Physician based (CCS-P) certification issued by the American Health Information Management Association (AHIMA). OR Certification Required: Possess and maintain a valid Certified Coding Associate (CCA) certification issued by the American Health Information Management Association (AHIMA) or Certified Professional Coder-Associate (CPC-A), or Certified Professional Coder-Hospital- Associate (CPC-H-A) or Certified Professional Coder-Payer- Associate (CPC-P-A), or Certified Inpatient Coder (CIC) certification issued by the American Academy of Professional Coders. OR Certification Required: Possess and maintain a valid certification: Certified Professional Coder (CPC), or Certified Outpatient Coder-Hospital (COC), or Certified Professional Coder-Payer (CPC-P) issued by the American Academy of Professional Coders. OR Certification Required: Possess and maintain a valid Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Tumor Registrar (CTR) Certification issued by the National Cancer Registrars Association (NCRA) AND six (6) months of experience (or its equivalent) abstracting and coding medical data in a hospital setting, medical office, outpatient clinic or managed care organization (i.e., HMO).
Applicants are required to attach a copy of their certification(s) to their application.

Nice To Haves

Experience with medical claims, reimbursement, and payment methodologies.
Experience identifying Fraud, Waste, and Abuse (FWA) through coding review, documentation analysis, and claims auditing.
Ability to analyze documentation, resolve coding discrepancies, and apply coding guidelines.
Commitment to ongoing learning and staying current with coding, reimbursement, and healthcare regulatory changes.

Responsibilities

Researching coding issues, guidelines, and reimbursement methodologies
Auditing medical claims for coding accuracy and payment discrepancies
Identifying potential Fraud, Waste, and Abuse (FWA), including inappropriate coding
Reviewing and validating provider contract configurations, reimbursement methodologies, fee schedule updates and coding changes
Collaborating with IT and operational teams to resolve coding, reimbursement, and claims processing issues
Supporting internal and external audits by providing coding expertise, documentation, and guidance