Certified Medical Coder

Certified Medical Coder

Job Summary

We are seeking a detail-oriented Certified Medical Coder to accurately assign medical codes to diagnoses, procedures, and services for billing and reimbursement purposes. The Medical Coder ensures compliance with coding guidelines, payer rules, and regulatory requirements while supporting timely claims submission and revenue integrity.

Key Responsibilities

• Review medical records, physician notes, operative reports, and diagnostic results to determine appropriate codes
• Assign accurate ICD-10-CM, CPT, and HCPCS codes in accordance with official coding guidelines
• Ensure documentation supports coded services and identify documentation gaps when necessary
• Maintain compliance with HIPAA, CMS, and payer-specific coding requirements
• Work closely with providers, billing staff, and auditors to resolve coding discrepancies
• Correct coding-related claim denials and support appeals as needed
• Stay current with annual coding updates, regulatory changes, and payer policies
• Meet productivity and accuracy benchmarks while maintaining high quality standards
• Participate in internal and external audits and quality assurance reviews

Qualifications

Education

Bachelor's degree in health information management, Medical Coding, or a related field preferred

Certification (Required)

One or more of the following

• CPC (Certified Professional Coder – AAPC)
• CCS (Certified Coding Specialist – AHIMA)
• CCS-P, CRC, or equivalent (role-dependent)

Preferred Skills

• 1–3 years of hands-on medical coding experience (inpatient, outpatient, or professional fee coding)
• Experience with EHR/EMR systems and coding software
• Prior experience with insurance claims, denials, or audits is a plus

Required Skills and Competencies

• Strong knowledge of ICD-10-CM, CPT, and HCPCS coding systems
• High attention to detail and accuracy
• Ability to interpret complex medical documentation
• Familiarity with payer guidelines, NCCI edits, and CMS regulations
• Strong analytical, organizational, and time-management skills
• Ability to work independently and meet deadlines
• Effective written and verbal communication skills

Preferred Qualifications

• Specialty coding experience (e.g., surgery, anesthesia, cardiology, orthopedics, behavioral health)
• Experience in U.S. healthcare revenue cycle management