Certified Medical Coder

3 months ago


Sierra Vista, United States Chiricahua Community Health Centers, Inc Full time
Job DescriptionJob Description
  • Job Title: Certified Medical Coder

    Reports To: Director, Revenue Cycle

    Job Summary: Reviews and ensures accuracy of medical coding for all services rendered by assigned providers including appropriate diagnostic documentation of risk and chronic conditions through a master understanding of specific ICD -10 codes and CPT II codes.


    Qualifications and Requirements:

    The requirements listed below are representative of the knowledge, skill, and/or ability required. Job duties may be modified at any time based on business needs.


    Essential Job Duties:

    • Assigns and sequences appropriate diagnostic/procedure billing codes, in compliance with third party payer requirements.
    • Acts as a coding claims review specialist.
    • Provides appropriate training and education to staff on current and future coding guidelines based on industry trends and best practices.
    • Researches and completes coding projects as assigned.
    • Reviews and modifies, if necessary, CPT, HCPCS and ICD-10 codes from assigned provider visit notes in a timely fashion, ensuring all supported codes are captured on the claim form(s) and submits to the health plan; closing both HCC and HEDIS/Stars care gaps.
    • Establishes themselves as the expert in CPT II and ICD-10 coding, and the relationship between specific coding practices and medical risk stratification.
    • Queries the provider for clarification, as needed using communication guidelines provided by the RCD/Physician Coder.
    • Identifies providers who may need additional educational training about their documentation and/or code selection.
    • Coding quality is at 95% accuracy or greater.
    • Collaborates with RCD/Physician Coder regarding planned provider coding education sessions.
    • Participates regularly required in CCHCI training, personal performance, and staff meetings.
    • Assists in addressing unbilled/unsubmitted encounters.

    Required Minimum Qualifications - Education, Experience, Certificates & Licenses:

    • High School Diploma or GED.
    • Current professional coding certification required through AAPC or AHIMA.
    • Documented Participation in training and education programs to maintain professional competence and skills applies.

    Preferred Qualifications - Education, Experience, Certifications & Licenses:

    • One year's experience in medical billing preferred.

    Required Language Skills:

    • Ability to comprehend and compose effective instructions, correspondence, and communications in English in both oral and written format.

    Physical Requirements:

    • Ability to occasionally exert enough force to move objects weighing up to 10 pounds.
    • Ability to continuously remain in a stationary position.
    • Ability to occasionally move about inside the workplace to access files, office machinery, etc.
    • Possesses hand-eye coordination and manual dexterity necessary to constantly operate computers, telephone, and other office machinery.
    • Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.
    • Ability to discern the nature of sounds at a normal spoken volume.

    Other Required Knowledge, Skills, and Abilities:

    • Ability to add, subtract, multiply and divide in all measure, using whole numbers, common fractions and decimals.
    • Ability to compute rate, ratio and percentage.
    • Ability to skillfully gather and analyze data.
    • Ability to perform a variety of assignments requiring independent judgment.
    • Ability to deal with challenges involving one or more variables in routine situations.
    • Knowledge of billing, medical records, health plans, and community health centers preferred.
    • Advanced, specialized knowledge of medical codes and coding procedures.
    • Thorough knowledge of ICD, CPT, and NDC codes.
    • Knowledge of HIPAA and Corporate Compliance rules and regulations.
    • Computer literacy required with proficiency in Microsoft Excel.
    • Knowledge of Electronic Health Records and Practice Management software preferred.

    Work Environment & Conditions:

    • Work environment is usually typical of an administrative office setting with no substantial exposure to adverse environmental conditions.
    • Work may be regularly performed remotely as assigned and may include extended hours including early mornings, evenings, and weekends.






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