Certified Medical Coder

This is an on-site position.

The Medical Coder plays a critical role in our healthcare team by ensuring accurate and compliant coding practices. Key responsibilities include performing chart reviews and coding audits, reviewing ICD-10 diagnoses codes, CPT, and HCPCS procedure codes assigned for patient evaluation and management. Additionally, the Medical Coder supports pre-or post-payment coding audits for benchmark and/or reimbursement recovery, and participates in other coding-related activities such as pre-appointment chart audits for HCC or risk adjustment, appeals of denied claims, and providing education to providers on documentation specificity to align with coding guidelines and federal, state, and regulatory requirements.

Key Job Responsibilities:

• Performs pre-appointment HCC or risk adjustment chart reviews, coding audits, or other coding-related projects
• Serves as an internal resource for coding inquiries from providers, Billing, Laboratory, Radiology, and other departments
• Provides real-time coding consultation and review of documentation to improve coding practices
• Trains providers and Billing staff on ICD-10 code usage
• Queries provider documentation as necessary
• Provides Billing staff with coding and documentation information for claim processing
• Maintains knowledge of current coding guidelines and standards, including updates, changes, additions, and deletions to ensure coding and billing compliance
• Communicates code changes to relevant departments
• Reviews and updates coding policies and procedures as needed
• Assigns ICD-10 and CPT codes to patient encounters as required
• Assists Revenue Cycle manager and billing staff on technical projects
• Serves as a resource for providers on medical documentation inquiries
• Completes other job duties as assigned by manager/supervisor

Qualifications:

• Associate's degree or higher
• Possession of AAPC or AHIMA credential, such as CPC, CPC-P, CPMA, RHIT, RHIA, CCS, or CCS-P
• Minimum two years' experience in the healthcare industry, particularly in HCC or risk adjustment, health information, chart audit, medical coding, or billing
• Prior coding experience is highly desirable
• Knowledge of medical terminology, anatomy, pathophysiology, pharmacology, CPT, ICD-10, clinical documentation, or medical billing processes
• Excellent verbal and written communication skills
• Experience with Microsoft Office (Word, Excel, PowerPoint) and Outlook
• Attention to detail and problem-solving skills
• Able to work independently with minimal supervision
• Experience in an FQHC or community health center setting is preferred

Language Requirements:

• Must be fluent in English, both spoken and written
• Fluency in other languages is an asset
• This is a full-time position

Status:

• This position is non-exempt under FLSA regulations
• This is not considered a high-risk position under OSHA guidelines

NEMS is committed to diversity and welcomes applicants from diverse backgrounds. Pursuant to the San Francisco Fair Chance Ordinance, we consider qualified applicants with arrest and conviction records for employment.

NEMS offers competitive benefits, including free medical, dental, and vision insurance for employees, spouses, and children, as well as a company contribution to 401(k).