Medical Coder job description

Job brief

We are seeking a detail-oriented Medical Coder to join our revenue cycle management team and ensure the integrity of our clinical data and billing processes. You will be responsible for reviewing patient encounters, applying accurate medical classification codes, and optimizing our reimbursement cycles. This role is perfect for a professional who thrives on accuracy, understands the nuances of clinical documentation, and wants to impact the financial sustainability of a top-tier healthcare facility. If you possess a sharp eye for detail and a commitment to coding excellence, we invite you to apply.

What is a Medical Coder?

A Medical Coder is a specialized healthcare professional responsible for translating medical records, physician notes, and laboratory reports into standardized alphanumeric codes. Utilizing systems like ICD-10-CM, CPT, and HCPCS, a Medical Coder bridges the gap between clinical documentation and financial reimbursement. By ensuring the highest level of coding accuracy, they maintain the financial health of healthcare providers while upholding strict compliance with HIPAA and payer-specific regulations.

What does a Medical Coder do?

A Medical Coder performs daily chart audits to ensure that clinical services, diagnoses, and procedures are captured with precise accuracy. They navigate Electronic Health Record (EHR) systems like Epic or Cerner to review physician documentation and assign the correct procedural and diagnostic codes required for successful insurance claims. Additionally, they work closely with billing departments and clinicians to resolve coding queries, minimize claim denials, and stay current on evolving CMS guidelines and local coverage determinations.

Key responsibilities

• Assign accurate ICD-10-CM, CPT, and HCPCS codes to inpatient or outpatient medical records based on physician documentation.
• Perform routine audits of patient charts to verify that clinical documentation supports the reported diagnoses and procedures.
• Communicate directly with physicians and clinical staff to clarify ambiguous documentation and improve coding specificity.
• Resolve claim denials and rejections by identifying coding errors and submitting corrected claims to insurance payers.
• Maintain compliance with HIPAA, NCCI edits, and other regulatory standards to minimize audit risks and fraudulent practices.
• Monitor quarterly updates to medical coding manuals and implement changes to ensure organizational billing standards remain current.
• Analyze coding performance metrics and denial rates to identify trends and recommend process improvements to management.
• Utilize computer-assisted coding (CAC) tools and EHR platforms to accelerate data entry while maintaining high accuracy rates.

Requirements and skills

• Active certification as a Certified Professional Coder (CPC) through AAPC or CCS through AHIMA.
• 3+ years of professional experience in medical coding across multispecialty or facility-based clinical settings.
• Advanced proficiency in navigating Electronic Health Record (EHR) platforms such as Epic, Cerner, or Athenahealth.
• In-depth technical knowledge of ICD-10, CPT, and HCPCS coding systems and their application to complex medical records.
• Strong understanding of medical terminology, anatomy, and physiology sufficient to interpret complex physician notes.
• Ability to explain technical coding logic and regulatory requirements to non-coding department heads and clinical stakeholders.
• Proven track record of maintaining a 95% or higher coding accuracy rate during routine quality assurance audits.
• Working knowledge of RCM (Revenue Cycle Management) workflows and common insurance payer reimbursement policies.

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