Coder Credentialed

Job Description

Job Description

About the Role:

As a Credentialed Coder, you will review clinical documentation and accurately assign diagnosis and procedure codes using ICD-10-CM, CPT, and HCPCS classification systems. Your expertise will ensure coding accuracy, compliance with federal and payer regulations, and timely reimbursement for healthcare services.

Preferred Qualifications:

• Current certification from AHIMA or AAPC, including one or more of the following:
  • Certified Coding Specialist (CCS)
  • Certified Professional Coder (CPC)
  • Certified Outpatient Coder (COC)
• Minimum of 2 years of recent hospital coding experience.
• Demonstrated knowledge of ICD-10-CM, CPT, and HCPCS coding systems.
• Knowledge of CMS regulations, Official Coding Guidelines, and payer policies.
• Proficiency with electronic health records (EHR) and coding software tools.
• Excellent analytical, organizational, and problem-solving skills.

Responsibilities:

• Review clinical documentation to accurately assign ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II codes.
• Ensure compliance with federal, state, and payer-specific coding guidelines and regulations.
• Validate medical necessity and documentation completeness to support accurate reimbursement.
• Stay current with annual coding updates, regulatory changes, payer requirements, and reimbursement methodologies.
• Maintain coding productivity and quality standards while meeting established turnaround times.
• Participate in audits and quality assurance activities to monitor coding accuracy and compliance.
• Experience using electronic health records, encoder software, and coding applications.

Knowledge, Skills & Abilities:

Successful candidates demonstrate exceptional attention to detail and the ability to interpret complex clinical documentation while applying official coding guidelines accurately. They possess strong critical thinking skills to identify documentation inconsistencies and collaborate effectively with providers and interdisciplinary teams. Experience with hospital reimbursement methodologies, coding technology, and regulatory compliance enables them to contribute to accurate billing, revenue integrity, and organizational success.