Billing Medical Coder

Billing Medical Coder One Community Health Sacramento

Paid Range: $29.00/hr - $37.00/hr (Based on skills and experience)

Location: Midtown Sacramento, CA (95811)

Schedule: Hybrid 12 days per week onsite.

Training Period: 46 weeks onsite, 5 days per week.

Job Description

The Billing Medical Coder is responsible for the day-to-day coding and billing operations for all services billable under grants, federal, state, and county programs, including Medicare, Medi?Cal, managed care and private insurance.

Essential Functions

• Review and adjudicate coding of services from documentation in a timely manner.
• Code physician/provider visit procedure notes to identify appropriate ICD?10 and CPT/HCPCS codes for charge processing.
• Ensure all diagnosis ICD?10 codes and procedure CPT/HCPCS codes are identified, sequenced, and coded accurately.
• Assign Evaluation and Management codes and key concepts documented in the patient note, following coding guidelines applicable to professional and technical standards.
• Research and identify correct codes for routine or new/unusual diagnoses and procedures not clearly listed in ICD?10 and CPT guidelines.
• Identify all procedures that may require modifiers (including 340B) for billing and reporting.
• Query providers as needed and consult with physicians and providers for clarification of clinical data when encountering conflicting or ambiguous information.
• Track cases with insufficient documentation to ensure proper coding and billing.
• Ensure documentation and coding meet federal, state, county, and payer regulations and guidelines.
• Maintain knowledge of current guidelines, policies, and regulatory updates (e.g., CMS, HIPAA).
• Participate in internal audits, compliance initiatives, and continuing education.
• Assist with claims submission and respond to coding-related denials and audits.
• Ensure coding productivity and accuracy standards are met or exceeded.
• Experience with EHR systems and coding software (e.g., Epic, EncoderPro).
• Excellent attention to detail, analytical skills, and communication abilities.
  

Additional Duties

• Provider Training Attend monthly provider meetings to advise providers of any changes to coding rules and regulations, field coding questions.
  

Minimum Requirements

• Current CPC certification through AAPC or AHIMA, kept current and in good standing.
• Expertise in medical coding, typically gained from 2 years of experience.
• Comprehensive knowledge of codes including payor guidelines, ICD?10, CPT billing, and E/M coding.
• Ability to work collaboratively with the Billing Manager to provide clinician education on coding guidelines.
• Ability to analyze medical records in an Electronic Health Record system to identify documentation deficiencies and verify documentation supports diagnoses, procedures, and treatments.
  

Preferred Background

• FQHC experience.
• Epic or OCH Epic experience.
• Ability to collaborate effectively across a broad spectrum of backgrounds and perspectives; inclusive thinking and interpersonal awareness.
  

Reasonable Accommodations

One Community Health endorses and supports the Americans with Disabilities Act of 1990 (ADA) and the California Fair Employment and Housing Act (FEHA). We are committed to providing reasonable accommodations to qualified individuals with disabilities who require accommodations to complete the application process. Contact ochhumanresources@onecommunityhealth.com for assistance.

Benefits

For more information on our comprehensive benefits, visit https://onecommunityhealth.com/careers/recruitment.

Additional Information

We only employ U.S. citizens and non-U.S. citizens authorized to work in the United States in compliance with federal law.

Job Details

• Seniority Level: Entry level
• Employment Type: Full?time
• Job Function: Health Care Provider
• Industry: Hospitals and Health Care