Certified Medical Coder

Job Description

Job Description

Position Purpose :

The Certified Medical Coder plays a crucial role in the Billing Department by ensuring precise and compliant coding of medical services. Under the guidance of the Billing Department Supervisor, the Coder will assign appropriate diagnosis and procedural codes for services provided by JWCH physicians, adhering to industry standards and legal requirements. This position involves validating and auditing coding practices to guarantee accuracy in billing, supporting optimal reimbursement, and maintaining adherence to regulatory guidelines.

Duties and Responsibilities :

• Serve as the primary liaison between providers and the Billing Department, effectively communicating to clarify diagnoses, procedures, coding, and documentation requirements.
• Recommend appropriate ICD-10-CM, CDT diagnosis codes, CPT codes, and HCPCS codes.
• Regularly review diagnosis and procedure coding within NextGen to ensure optimal billing accuracy.
• Collaborate with clinicians on the correct use of ICD-10 codes to enhance HEDIS, HCC, and other performance incentives submitted through claims data.
• Work with the Quality Insurance Team to ensure coding supports Meaningful Use and other clinical incentive payments.
• Provide compliance and coding training to new providers during onboarding and orientation.
• Ensure all codes are current and active.
• Code based on documentation in the medical record.
• Report missing or incomplete documentation.
• Evaluate and ensure that all codes are submitted to third-party payers and IPA.
• Act as a resource for insurance resolutions and coding questions.
• Follow coding guidelines and legal requirements to ensure compliance with federal and state regulations.
• Support the Billing Supervisor in improving current medical billing practices.
• Conduct monthly coding audits and maintain up-to-date outcome reports.
• Perform other duties as assigned.

Qualifications :

Preferred :

Employee Benefits :

At JWCH Institute, Inc., we believe in taking care of those who take care of others. If you work 30+ hours per week, you’ll enjoy competitive pay and a robust benefits package that includes :

Become part of a team where your work matters. Apply today and help us change lives, one patient / client at a time.

JWCH Institute, Inc + Wesley Health Centers is an Equal Opportunity and Fair Chance Employer.