Certified Medical Coder III

1 month ago

Charlotte, North Carolina, United States One Medical Full time

About Us

One Medical is a primary care solution challenging the industry status quo by making quality care more affordable, accessible and enjoyable. But this isn't your average doctor's office. We're on a mission to transform healthcare, which means improving the experience for everyone involved - from patients and providers to employers and health networks. Our seamless in-office and 24/7 virtual care services, on-site labs, and programs for preventive care, chronic care management, common illnesses and mental health concerns have been delighting people for the past fifteen years.

In February 2023 we marked a milestone when One Medical joined Amazon. Together, we look to deliver exceptional health care to more consumers, employers, care team members, and health networks to achieve better health outcomes. As we continue to grow and seek to impact more lives, we're building a diverse, driven and empathetic team, while working hard to cultivate an environment where everyone can thrive.

The Opportunity

As a member of the One Medical's Senior Health Revenue Cycle team, the Coder III will be responsible for supporting One Medical's Clinical and Revenue Cycle teams in reviewing the coding accuracy of claims. This role reports into the Sr. Manager of Revenue Cycle.

Responsible for coding all claims for Senior Health inclusive of CPT, ICD-10-CM, and HCPCS. Responsible for the review and completion of email requests in a timely manner as well as reviewing. Demonstrates working knowledge of all facets of the role, relevant regulations, and organizational and departmental policies and procedures. Performs other duties and projects as assigned. Performs all duties in accordance with regulatory requirements and internal organizational policies and procedures.

What you'll Likely Work On:

  • Managing multiple coding related projects and ensuring deliverables are up to One Medical standards while being turned around in an acceptable time frame.
  • Remaining current on CPT, ICD-10-CM coding guidelines, AHA Coding Clinic Guidance and CMS Risk Adjustment guidance.
  • Assign appropriate ICD-10-CM, CPT, and other relevant codes to office visits, procedures, and diagnoses in a production environment.
  • Work collaboratively with the Medicare Risk Operations team to ensure positive program outcomes.

What You'll Need:

  • 2+ years as an outpatient risk adjustment coder/auditor required
  • 1+ years experience in Medicare/Medicare Advantage required
  • CPC certification through AAPC or CCS certification through AHIMA required
  • CRC must be obtained within one year of hire
  • Must have strong experience in Microsoft or Google suite in spreadsheets and PowerPoint
  • Demonstrates knowledge of health systems operations, including an understanding of reimbursement methodologies and coding conventions
  • Demonstrates ability to perform accurate and complete chart reviews for HCC Risk Adjustment
  • Possesses advanced knowledge and understanding of HCC Risk Adjustment, coding and documentation requirements.
  • Previous experience in a coding production environment.
  • Demonstrates ability to identify and communicate trends in provider coding and documentation.
  • Strong written, verbal, communication, and attention to detail skills.
  • Strong organizational, analytical, problem solving, and time management skills
  • Works effectively and efficiently within a team environment.
  • Adaptable to shifting priorities and demonstrates willingness to do what it takes to meet client and team needs.
  • Complies with policies and procedures for confidentiality of all patient records and security of systems.
  • Ability to work independently and meet quality of work and workload expectations
  • Ability to manage multiple projects

One Medical is committed to fair and equitable compensation practices. The base hourly range for this role is $16.00 to $30.50 per year. However, actual compensation packages are based on several factors that are unique to each candidate. These factors include, but are not limited to, job related knowledge and skill set, depth of experience, certifications and/or degrees, and specific work location. The total compensation package for certain roles may also include additional components such as a sign-on bonus, annual performance bonus, equity grants in the form of RSUs, medical and other benefits and/or other applicable incentive compensation plans. For more information, please visit

One Medical is an equal opportunity employer, and we encourage qualified applicants of every background, ability, and life experience to contact us about appropriate employment opportunities.

One Medical participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. Please refer to the E-Verification Poster (English/Spanish) and Right to Work Poster (English/Spanish) for additional information.

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