PACE Medical Coder (Hybrid)

San Ysidro Health•San Diego, CA

2d•Hybrid

About The Position

The PACE Medical Coder reviews clinical documentation and diagnostic results to verify accurate assignment of ICD-10-CM, CPT, and HCPCS codes in accordance with Official Guidelines for Coding and Reporting. The position is hybrid and primarily remote, with attendance required at quarterly on-site meetings and additional on-site work as business needs require. Candidates must currently live in California or be willing to relocate before employment. The coder reviews patient records for diagnoses, procedures, and services; verifies codes in the electronic health record; communicates with providers about documentation; identifies chargeable items; and applies diagnosis and procedure sequencing guidelines. The role also tracks encounter reports, prioritizes work to meet departmental timelines, maintains coding knowledge, serves as a coding resource, and participates in continuing education. The employee is expected to follow organizational policies, procedures, professional standards, and confidentiality requirements, and may perform other related duties as assigned. The role requires a high school diploma or GED and one year of medical coding experience, along with a current CPC certification from AAPC or an AHIMA certification. The coder should have knowledge of medical terminology, anatomy and physiology, diagnostic tests, procedures, pathology terminology, drug reference resources, ICD-10-CM, HCPCS/CPT, and HCC coding and abstracting procedures. Computer and software proficiency, typing skills, communication and customer service skills, organization, attention to detail, collaboration, and problem-solving are also required. Work may involve prolonged standing and walking; reaching, stooping, bending, kneeling, crouching, manual dexterity, and mobility. The work may take place in a noisy setting and may require handling multiple activities simultaneously. Evening and weekend work may be required. Employment is subject to pre-employment screening and compliance with mandated vaccinations and boosters.

Requirements

One year of medical coding experience.
Current CPC certification from the American Academy of Professional Coders (AAPC) or AHIMA certification.
High school diploma or GED equivalent.
Good oral and written communication skills.
Good customer service skills.
Extensive knowledge of medical terminology, human anatomy, and physiology.
Knowledge of diagnostic tests, procedures, pathology terms, and drug reference books.
Knowledge of ICD-10-CM and HCPCS/CPT, HCC coding, and abstracting procedures.
Proficiency in typing and experience using computers and software systems.
Ability to collaborate, problem-solve, manage multiple activities, and stay organized and detail-oriented.
Must currently live in California or be willing to relocate before employment.
Ability to attend quarterly on-site meetings and additional on-site work as business needs require.
Willingness to work evenings and/or weekends if required.
Compliance with mandated vaccinations and boosters and completion of pre-employment requirements, including I-9, physical, background and reference checks, application, new-hire orientation, and pre-employment PPDs.

Responsibilities

Review chart progress notes and patient documentation for diagnoses, procedures, and services performed by physicians and other qualified healthcare providers.
Verify diagnostic and procedural codes in the electronic health record using ICD-10, CPT, and HCPCS classifications.
Communicate with providers about documentation to support proper coding and reimbursement.
Identify chargeable items in progress notes and assign appropriate CPT/HCPCS codes.
Apply diagnosis sequencing guidelines and select the principal diagnosis and procedure according to ICD-10 guidelines.
Track open and closed encounter reports to ensure all clinic patients are properly coded.
Organize and prioritize work so records are coded within departmental time frames.
Maintain knowledge of anatomy and physiology to interpret medical classifications, including for complicated encounters and cases.
Serve as an expert resource to other coders and personnel in other departments on coding questions and issues.
Participate in continuing education, in-service training, and other activities to maintain and improve competence.
Follow organizational policies, procedures, processes, core competencies, conduct standards, and values.
Collaborate with the team, solve problems, communicate effectively, and treat patients and employees with dignity and courtesy.
Maintain confidentiality of electronic patient medical records and keep the work area clean, safe, and organized.
Attend required meetings, participate on committees as directed, and assist with maintaining or revising departmental policies and procedures.
Perform other related duties as assigned or requested.