Certified Coder

Community health is about more than just vaccines and checkups. It’s about giving people the resources they need to live their best lives. At Neighborhood, this is our vision. A community where everyone is healthy and happy. We’re with you every step of the way, with the care you need for each of life’s chapters. At Neighborhood, we are Better Together.

As a private, non-profit 501(C) (3) community health organization, we serve over 500,000 medical, dental, and behavioral health visits from more than 100,000 people annually. We do this in pursuit of our mission to improve the health and happiness of the communities we serve by providing quality care to all, regardless of situation or circumstance.

We have been doing this since 1969 and it is our employees that make this mission a reality. Regardless of the role, our team focuses on being compassionate, having integrity, being professional, always collaborating, and consistently going above and beyond. If that sounds like an organization you want to be a part of, we would love to have you.

We are seeking a highly skilled and detail-oriented Certified Coder to join our team. The primary focus of this role will be to manage and ensure the accuracy of coding for medical services, as well as conduct provider audits to ensure compliance with regulatory standards. The successful candidate will have extensive knowledge of medical coding, coding systems (CPT, ICD-10, HCPCS), and healthcare regulations. This individual will play a key role in maintaining the integrity of our coding practices and assisting in audits to ensure proper documentation and reimbursement processes. This is a hybrid position. Candidates must be located in Riverside or San Diego County.

Responsibilities

Medical Coding

• Accurately assign medical codes (ICD-10, CPT, HCPCS) for a variety of healthcare services.
• Review patient medical records and documentation to ensure that all coding is accurate and compliant with federal and state regulations.
• Ensure proper coding for diagnoses, procedures, and services to facilitate billing and reimbursement.
• Review and update coding knowledge to remain current with the latest coding updates and changes.
• Collaborate with healthcare providers to clarify documentation and coding discrepancies when necessary.

Provider Audits

• Conduct comprehensive audits of medical providers’ coding and billing practices to ensure compliance with federal and state guidelines.
• Identify coding errors, overbilling, underbilling, or other discrepancies that may lead to claim denials or legal/regulatory issues.
• Provide feedback and recommendations for improvements to providers based on audit findings.
• Assist in developing and maintaining auditing policies and procedures.
• Ensure audit processes are in line with current industry standards and regulatory requirements (such as HIPAA, CMS, etc.).
• Prepare detailed audit reports and present findings to management, including any corrective action plans.

Compliance and Education

• Stay updated on the latest industry regulations, payer requirements, and healthcare trends to ensure compliance.
• Assist in training and educating providers and staff on coding best practices, documentation standards, and regulatory changes.
• Support audits by gathering relevant documentation and providing coding expertise.

Collaboration and Communication

• Work closely with other departments, including billing and clinical teams, to ensure efficient workflows and resolve coding issues.
• Communicate effectively with healthcare providers to clarify documentation or coding concerns.
• Provide coding support and guidance to team members when necessary.

Quality Assurance

• Continuously monitor and improve coding processes to enhance accuracy and compliance

Qualifications

Education/Experience

• Minimum of 3-4 years of experience in medical coding, with a focus on provider audits and compliance required
• Experience in conducting audits and reviewing medical records for coding accuracy and regulatory compliance required
• Valid Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification from an accredited body (e.g., AAPC, AHIMA) required.
• Experience with Electronic Health Record (EHR) systems and coding software preferred
• Knowledge of payer-specific guidelines and reimbursement methodologies preferred
• FQHC coding experience preferred

Additional Qualifications(Knowledge, Skills and Abilities)

• In-depth knowledge of medical coding systems (ICD-10, CPT, HCPCS).
• Familiarity with medical terminology, anatomy, and healthcare billing procedures.
• Strong understanding of healthcare compliance standards (HIPAA, CMS, etc.).
• Ability to analyze and interpret medical records and documentation for accurate coding.
• Excellent verbal and written communication skills, including superior composition, typing and proofreading skills
• Ability to interpret a variety of instructions in written, oral, diagram, or schedule form
• Ability to successfully manage multiple tasks simultaneously
• Excellent planning and organizational ability
• Ability to work as part of a team as well as independently
• Ability to work with highly confidential information in a professional and ethical manner
• Ability to work under pressure and be flexible with changing site needs. Can work with people of all social and ethnic backgrounds and maintain confidentiality. Able to train and manage staff in a collaborative manner.

Physical Requirements

• Ability to lift/carry 10 lbs/weight
• Ability to stand for long periods of time

Neighborhood Healthcare offers a generous benefit plan that includes: Partially company paid Medical, Dental, and Vision Plans. Two plus weeks of vacation, Nine Holidays including two Floating Holidays of your choosing, Sick/Personal time, Volunteer Time Off (VTO), 403b Retirement plan (similar to a 401k), optional Health and Wellness events, and much more!

Pay range: $32.40-$45.34 per hour, depending on experience.

Compensation Disclosure: The posted salary range reflects the designated pay grade for this position. While this range represents the broader classification of the role, actual compensation will be based on several factors, including but not limited to: the candidate’s overall knowledge, skills, and experience, market data and industry benchmarks, internal equity within the organization, Budgetary considerations and organizational needs. As a result, placement within the range is not guaranteed, and the full pay grade range may not be utilized.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.