We are seeking an experienced and detail-oriented
Certified Medical Coder with strong
EPIC EMR experience and a background in
Primary Care and/or Urgent Care coding to join our healthcare team. This role is responsible for reviewing clinical documentation, assigning accurate diagnosis and procedure codes, ensuring coding compliance, and supporting optimal reimbursement while maintaining adherence to payer and regulatory guidelines.
The ideal candidate possesses extensive knowledge of
ICD-10-CM, CPT, HCPCS, and Evaluation & Management (E&M) coding, with the ability to work efficiently in a fast-paced outpatient environment while maintaining a high level of accuracy and compliance.
Key Responsibilities
- Review and assign accurate ICD-10-CM, CPT, and HCPCS codes for Primary Care and Urgent Care patient encounters.
- Analyze provider documentation to ensure coding accuracy, completeness, and compliance with coding guidelines.
- Validate and assign appropriate E&M levels based on current coding regulations and documentation requirements.
- Conduct routine coding audits and documentation reviews to ensure services billed are supported by medical records.
- Identify and resolve coding discrepancies, missing documentation, claim edits, and billing issues prior to claim submission.
- Collaborate with physicians, advanced practice providers, and clinical staff to improve documentation quality and coding accuracy.
- Monitor coding denials, identify root causes, and recommend corrective actions to reduce future denials and improve reimbursement.
- Ensure compliance with federal regulations, payer policies, CMS guidelines, and organizational coding standards.
- Stay current on coding updates, regulatory changes, and payer-specific requirements affecting outpatient coding.
- Assist with provider education and training regarding coding best practices, documentation requirements, and compliance standards.
- Support revenue cycle initiatives by improving coding accuracy, clean claim rates, and overall reimbursement performance.
- Participate in internal and external coding audits as needed.
- Maintain productivity and quality standards while meeting established turnaround times.
Qualifications
- 5+ years of medical coding experience.
- Experience performing coding audits and documentation reviews.
- Experience providing coding education and feedback to healthcare providers.
- Familiarity with Medicare, Medicaid, and commercial payer policies.
- Multi-specialty outpatient coding experience.
- Experience supporting revenue cycle management initiatives.
- Current coding certification from an accredited organization, such as:
- CPC (Certified Professional Coder)
- CCS-P (Certified Coding Specialist – Physician-Based)
- COC (Certified Outpatient Coder)
- Minimum of 3 years of professional medical coding experience in an outpatient setting.
- Hands-on experience using EPIC EMR.
- Strong working knowledge of:
- ICD-10-CM
- CPT
- HCPCS
- Evaluation & Management (E&M) coding guidelines
- Experience coding for Primary Care and/or Urgent Care services.
- Understanding of medical necessity requirements, payer guidelines, and coding compliance regulations.
- Strong analytical, organizational, and problem-solving skills.
- Excellent attention to detail and accuracy.
- Strong written and verbal communication skills.
- Ability to work independently while managing multiple priorities and deadlines.
Perks
- Permanent Work From Home
- Leave Credits
- Monetary Allowance
- Annual Bonus
- Weekly Paychecks
- Fixed Weekends Off
- Thriving Company Culture with Complete Autonomy
- Exclusive Specialized Training Programs
- Unlock Your Potential with a Highly Competitive Salary
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Who are we
BizForce is one of the fastest-growing global outsourcing companies in the world, founded in the US in Tucson, Arizona and is now operational in PH!
Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.
