Coder-Certified I

Job Description

Description:

Southeast Primary Care Partners is seeking a dedicated and detail-oriented Certified Coder to join our dynamic team. The successful candidate will play a crucial role in accurately coding healthcare claims for reimbursements, ensuring compliance with federal regulations, and contributing to the efficiency and effectiveness of our healthcare services. Certified Coder reviews medical records to assure proper billing. Participates in audits to evaluate if all selected codes are accurate and develops methodologies to improve coding issues identified. Codes must meet QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Position Summary:

Requirements:

Key Responsibilities:

Review patients' medical records to extract relevant information needed for billing and coding.

Apply appropriate ICD-10, CPT, and HCPCS Level II code assignments to ensure accurate and timely billing.

Work closely with healthcare providers and billing teams to clarify discrepancies, ensure documentation compliance, and verify the accuracy of coded data.

Stay current with coding guidelines, trends, and federal regulations to ensure up-to-date knowledge and compliance.

Conduct regular audits to ensure coding accuracy, address any discrepancies, and provide feedback and education to clinical staff as needed.

Assist the billing department in the resolution of coding-related denials and rejections, including preparing appeals as necessary.

Participate in educational sessions, workshops, and meetings to enhance coding knowledge and skills.

Requirements:

Certification as a medical coder from an accredited organization (e.g., CPC).

>1yr of coding experience in a primary care setting.

Proficiency in ICD-10, CPT, and HCPCS Level II coding standards.

In-depth knowledge of medical terminology, pharmacology, and disease processes.

Strong analytical and problem-solving skills.

Excellent attention to detail and organizational skills.

Solid communication skills, both written and verbal.

Ability to work independently and collaboratively within a team environment.

Familiarity with Electronic Health Record (EHR) systems and medical billing software.

Preferred:

Experience with coding audits and compliance reviews.

Knowledge of federal regulations regarding medical coding and billing.

Key physical and mental requirements:

Ability to lift up to 50 pounds

Ability to push or pull heavy objects using up to 50 pounds of force

Ability to sit for extended periods of time

Ability to stand for extended periods of time

Ability to use fine motor skills to operate office equipment and/or machinery

Ability to receive and comprehend instructions verbally and/or in writing

Ability to use logical reasoning for simple and complex problem solving

FLSA Classification: Non-exempt

Southeast Primary Care Partners is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

12/2024

Full-time