The Medical Coder is responsible for independently reviewing, analysing, and resolving all assigned front-end claims to ensure accurate and timely claim submission. This position focuses on identifying and correcting coding-related issues prior to claim transmission, applying established coding guidelines, payer requirements, and organizational policies. The Medical Coder works closely with revenue cycle partners to prevent claim rejections, support clean claim rates, and promote efficient reimbursement processes. This role requires strong attention to detail, foundational coding knowledge, and the ability to work independently in a fast-paced environment.
A Day in the Lif
Averages 10 front-end holds per hou
Maintains a minimum of 90% coding accuracy
Assigns ICD-10-CM and CPT codes with appropriate modifiers for services provided in the professional fee environment
Reviews medical records and all applicable documentation to determine appropriate codes for documented services and diagnoses
Ensures all diagnosis codes meet local and national medical necessity guidelines
Utilizes internal coding resources, payer guidelines, and other reference materials to ensure accurate and compliant coding for all assigned services
Follows all HIPAA regulations and upholds the highest standards of privacy and confidentiality
Maintains current knowledge of laws, regulations, payer policies, and industry guidance impacting compliant coding practices
Independently reviews and resolves all assigned front-end claim holds
Actively participates in department meetings, one-on-one meetings, and mentorship meetings with the assigned Coding Team Lead
Escalates identified client trends to the assigned Coding Team Lead
Escalates all coding-related questions to the assigned Coding Team Lead for guidance and clarification
Maintains and completes all CEU requirements
Performs other duties or tasks as assigned
What You Ne
Must hold a current AAPC or AHIMA Certification for a minimum of 3 year
Strong working knowledge of CPT, ICD-10-CM, medical terminology, anatomy and physiology, and state and federal Medicare reimbursement guideline
Familiarity with proper English grammar, usage, and professional documentation standard
Ability to research and analyze data, draw logical conclusions, and resolve coding or documentation issue
Ability to read, interpret, and apply policies, procedures, laws, and regulation
Ability to accurately read and interpret medical documentation, clinical terminology, and documented procedure
Demonstrated ability to exercise independent judgment in coding and claim resolutio
Excellent written and verbal communication skills, including the ability to prepare reports, clarify documentation needs, and maintain collaborative working relationships with physicians and staf
Strong commitment to maintaining confidentiality and safeguarding protected health informatio
Prior experience working in a medical billing environment with strict adherence to HIPAA compliance requirement
Demonstrated proficiency in Microsoft Office Suite (Word, Excel, Outlook, Teams
Minimum of 3+ years of professional coding experienc
We offer competitive benefits to set you up for success in and outside of wo
Here’s What We O
fferGenerous Paid Time Off: Recharge and relax with 20 days of fixed time off per year, in addition to company holidays—because we believe work-life balance fuels performa
nce.Best-in-Class Parental Le ave: Spend quality time with your growing family. We offer one of the industry’s most generous parental leave policies to support you during life’s most important mome
nts.Recognition & Rewa rds: We celebrate wins—big and small. Get rewarded with monetary incentives and company-wide recognition for your impact and dedication. Your hard work won’t go unnoti
ced.Comprehensive Insurance Cover age: Stay covered with medical, dental, and vision insurance, plus 100% company-paid short- and long-term disability and basic life insurance. Optional perks include discounted legal aid and pet insura
#J-18808-Ljbffr