Job Description
The Certified Medical Coder will be responsible for ensuring accurate and compliant coding of diagnoses, procedures, and medical services provided at HealthyU Clinics. This role requires a thorough understanding of ICD-10, CPT, and HCPCS coding systems, along with a commitment to maintain confidentiality, accuracy, and efficiency in coding processes. The CPC will collaborate closely with providers, billing teams, and management to optimize reimbursement and reduce claim denials.
Key Responsibilities:
- Medical Coding and Billing: Review and assign appropriate codes to diagnoses, procedures, and services provided at HealthyU Clinics to ensure accurate and timely billing.
- Compliance: Ensure all coding practices comply with federal and state regulations, including HIPAA, as well as insurance company guidelines.
- Audits and Quality Assurance: Conduct internal coding audits to verify coding accuracy, identify trends in coding discrepancies, and report findings to the Billing Manager.
- Collaboration with Providers: Work with physicians, nurse practitioners, and other providers to clarify diagnosis and procedures for accurate coding.
- Documentation Review: Regularly review clinical documentation to ensure it meets the necessary requirements for coding and billing and provide feedback or training to improve documentation quality when needed.
- Denial Management: Investigate coding-related claim denials, initiate corrections, and resubmit claims as required to maximize revenue capture.
- Continuous Education: Stay current on coding changes, healthcare regulations, and insurance policies, and participate in ongoing training as required by HealthyU and CPC certification standards.
Requirements
Certification: Must hold a current Certified Professional Coder (CPC) certification
- Education: High school diploma or equivalent required; associate degree in health information management or related field preferred.
- Experience: Minimum of 2 years of coding experience in a healthcare setting, preferably in primary care or specialty clinics.
- Technical Skills: Proficiency in electronic health record (EHR) systems and coding software (experience with [specific EHR if applicable] is a plus).
- Knowledge Base: Strong understanding of medical terminology, anatomy, physiology, and coding principles, including ICD-10, CPT, and HCPCS.
- Communication Skills: Excellent written and verbal communication skills, with the ability to collaborate with healthcare providers and team members.
- Attention to Detail: High degree of accuracy and attention to detail in all aspects of coding and billing processes.
- Problem-Solving: Ability to analyze, research, and resolve coding and billing discrepancies effectively.
Working Conditions:
- This position may involve both on-site and remote work, depending on departmental needs.
- Standard office environment with occasional extended hours as needed.
Salary Description
$24-26 per hour HealthyU Clinics
Job Tags
Hourly pay, Remote job,