Certified Coder

SB CLINICAL PRACTICE MANAGEMENT PLAN INC; Saint James (NY); Hybrid; USD 38,448 - 48,036; Full time

Job summary

SB CLINICAL PRACTICE MANAGEMENT PLAN INC is seeking a Certified Coder for Stony Brook Children's Service in St. James, NY. This full-time role requires analyzing and coding medical documentation to ensure compliance with guidelines and procedures. Candidates must have a CPC certification or equivalent experience.

The successful candidate will perform essential duties such as coding for reimbursement, resolving discrepancies, and maintaining accounts. A working knowledge of coding requirements and proficiency in Microsoft Office are also needed.

Qualifications

• Certified Professional Coder certification required.
• Working knowledge of coding requirements.
• 5 years of experience in lieu of an Associate’s degree.

Responsibilities

• Provide complex and technical assignments relating to medical coding.
• Analyze, code, and abstract information for diagnoses and procedure codes.
• Resolve discrepancies on coding related issues.
• Review and correct rejected claims from third-party carriers.

Skills

Certified Professional Coder (CPC)

Excellent expressive and written communication skills

Highly organized

Proficient in Microsoft Office Word and Excel

Education

Associate’s Degree or 5 years of experience

Job description

Certified Coder – Stony Brook Children’s Service, UFPC

Location: St. James, NY

Schedule: Full Time

Remote Work: At the Manager's discretion, this role may be eligible for remote work after 90 days.

Pay: $27.91 – $34.87

Our compensation philosophy aims to provide marketable compensation programs and to compensate employees based on relevant experience and education. Salaries vary depending on experience, education and current market for the position.

SUMMARY

This incumbent is responsible for reviewing and analyzing physicians’ documentation, CPT, and ICD‑10 diagnosis codes. The coding function also ensures compliance with established coding guidelines, third‑party reimbursement policies, regulations, and accreditation guidelines.

Job Duties & Essential Functions

• Provide a variety of complex and technical assignments relating to medical coding.
• Analyze, code, and abstract information for the purpose of assigning and entering appropriate and consistent diagnoses and procedure codes for reimbursement.
• Resolve discrepancies on coding related issues.
• Review and correct rejected claims from various third‑party carriers.
• Maintain CPMP account notification/accounts receivable report (IDX) and ICD-10 coding.
• Account maintenance – IDX pending report.
• Track all IDX record requests.
• Maintain PK files for validity, coding/billing errors.
• Monitor TES Open Encounter file.
• CLIA renewals for all sites.
• Perform all other duties as assigned by management.

Required Qualifications

• Certified Professional Coder (CPC) Certification.
• Associate’s Degree, or in lieu of an Associate’s degree, 5 years of experience.
• Working knowledge of coding requirements.
• Excellent expressive and written communication skills.
• Highly organized.
• Proficient in Microsoft Office Word and Excel.

Physical Demands

This position is largely sedentary and requires the employee to remain stationary for a majority of the day. The employee must be able to communicate with patients, staff, and medical providers, exchanging accurate information in these situations.

Equal Employment Opportunity

CPMP provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, gender identity or expression, or any other legally protected status.

CPMP expressly prohibits any form of workplace harassment based on the aforementioned protected categories. Improper interference with the ability of CPMP’s employees to perform their job duties may result in discipline up to and including discharge.