Certified Professional Coder

Job Description

Job Description

Certified Professional Coder
Medical Billing Department
Exceed Healthcare

Why join Exceed Healthcare?

At Exceed Healthcare, our mission is simple: improving lives through innovation . We are redefining healthcare by delivering cutting-edge medical services, expanding access through seamless virtual care, and always putting patients at the center of everything we do.

Our vision is to lead the future of healthcare by exceeding expectations through technology, strategic insight, and a deep commitment to excellence.

We value integrity, respect, accountability, and collaboration. We foster a diverse and inclusive culture where courage and resiliency thrive—and where every team member plays a vital role in making an impact.

Join us to be part of a forward-thinking team that prioritizes exceptional patient care, supports your growth, and believes in leading from every role.

Job Summary:

The Certified Professional Coder is responsible for reviewing medical documentation and assigning accurate diagnostic and procedural codes to support compliant billing, timely reimbursement, and high-quality health data. This role helps reduce denials and revenue leakage by ensuring claims are complete, accurate, and aligned with coding guidelines and regulatory requirements. The position also supports ongoing education, reporting, and process improvement to strengthen documentation integrity and coding performance across the organization.

Job Duties:

• Evaluate medical record documentation and charge-ticket coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support outpatient visits and that data complies with legal standards and guidelines.

• Interpret medical information such as diseases or symptoms and diagnostic descriptions and procedures to assign and sequence the correct ICD-9-CM and CPT codes accurately.

• Review state and federal Medicare reimbursement claims for completeness and accuracy before submission to minimize claim denial.

• Evaluate records and prepare reports on such topics as the number of claims denied or documentation or coding issues for review by management.

• Develop and update procedures manuals to maintain standards for correct coding, minimize the risk of fraud and abuse, and optimize revenue recovery.

• Provide technical guidance to physicians and other staff in identifying and resolving issues or errors, such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, and/or codes that do not conform to approved coding principles/guidelines.

• Read bulletins, newsletters, and periodicals and attend workshops to stay abreast of issues, trends, and changes in laws and regulations governing medical record coding and documentation.

• Educate and advise staff on proper code selection, documentation, procedures, and requirements.

• Identify training needs, prepare training materials, and conduct training for physicians and support staff to improve skills in the collection and coding of quality health data.

Qualifications:

Education and Experience:

• Possession of an Accredited Record Technician’s certification (ART) or Certified Coding Specialist designation (CCS) issued by the American Health Information Management Association.

• Five years of experience in medical record coding.

Skills and Competencies:

• Knowledge of ICD-9-CM and CPT coding guidelines; medical terminology; anatomy and physiology; state and federal Medicare reimbursement guidelines; English grammar and usage.

• Ability to research and analyze data, draw conclusions, and resolve issues; read, interpret, and apply policies, procedures, laws, and regulations.

• Ability to read and interpret medical procedures and terminology.

• Ability to develop training materials, make group presentations, and train staff.

• Ability to exercise independent judgment.

• Excellent written and verbal communication skills to prepare reports and related documents and to maintain working relationships with physicians and other staff.

• Ability to maintain confidentiality.

Key Performance Indicators:

• Coding accuracy rate

• Clean claim rate / first-pass claim acceptance

• Coding-related denial rate and rework volume

• Coder productivity (charts coded per day or turnaround time)

• Documentation query rate and resolution timeliness

• Audit/compliance score and adherence to coding guidelines

• Training completion and post-training improvement in coding quality

We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.