Medical Coder

The Medical Coding Specialist is responsible for reviewing clinical documentation to assign accurate ICD-10, CPT, and HCPCS codes. This role ensures compliant claims submission, supports the revenue cycle by minimizing claim denials, and maintains strict adherence to federal and state healthcare regulations. Supports the success of a high-performing shared services organization by helping to champion and drive the long-term Health System Shared Services vision. Helps foster an environment in which continuous improvement in business processes and services is welcomed and recognized. Responsibilities: Translate diagnoses, procedures, and medical services for all Banyan services including behavioral health, psychiatry, and primary care into standardized universal codes for billing Ensure all charges are reviewed, coded, and posted within 72 hours Collaborate with the billing team to resolve coding-related claim edits, research denials, and facilitate insurance reimbursement Communicate with healthcare providers to clarify ambiguous documentation and improve clinical documentation integrity Maintain strict confidentiality and compliance with HIPAA guidelines, CMS regulations, and standard medical coding conventions Stay current on all changing coding guidelines, regulatory standards, and Medicare/payer announcements Review and advising about HEDIS measures Educate Physicians regarding proper billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation Prepares and submits to the supervisor the reports required Ability to maintain effective working relationships with employees Collaborate with RCM Leadership when changes are necessary Education: An Associate degree in Health Information Technology is preferred. Work experience may substitute for a degree. Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) is required. Knowledge: Advanced knowledge of medical and insurance terminology Advanced Knowledge and demonstrated proficiency in medical insurance plans, billing and regulations, and manage care plans. Strong ability to multi-task and work under pressure to meet deadlines. Working knowledge of applicable Federal, State, and local laws and regulations desired Working knowledge of CPT and ICD-10 codes as they relate to financial clearance Strong knowledge of medical terminology, anatomy, physiology, and experience navigating Electronic Health Record (EHR) systems. Proven experience in medical coding, with proficiency in ICD-9, ICD-10, CPT coding Excellent attention to detail, organizational skills, and ability to interpret complex clinical documentation Experience: Minimum 2-3 years of experience as a certified coder Previous experience with HEDIS, Risk-Adjustment, and value-based contracts Experience in behavioral health, psychiatry, and primary care coding Job Type: Full-time 100% Paid Health Insurance (Employee Base Plan) 100% Employer-Paid Basic Life Insurance Dental, Vision, Short-Term Disability (STD), Long-Term Disability (LTD), Secondary Health Insurance, and Other Voluntary Benefit Plans 403(b) Retirement Plan with Employer Matching Student Loan Forgiveness Opportunities Potential HRSA Student Loan Repayment for eligible licensed positions* Opportunities for Career Growth and Professional Development Certain licensed positions working in qualifying outpatient settings may be eligible for the HRSA National Health Service Corps Loan Repayment Program. Eligibility is subject to HRSA requirements and position responsibilities and will be confirmed during the hiring process. #J-18808-Ljbffr Banyan Health