Certified Medical Coder — Audits & Revenue Cycle

Three-Crosses-Regional-Hospital; Las Cruces (NM); On-site; USD 54,000 - 76,000; Full time

Job summary

The Certified Coder at Three Crosses Regional Hospital will code ICD-10-CM/ICD-10-PCS and CPT data for administrative and clinical records, ensuring compliance with federal and state regulations and hospital policies. The role requires high ethical standards and confidentiality.

Key duties include pre- and post-payment claim analysis, chart reviews, audit scheduling, documentation of findings, education of providers on coding practices, and collaboration with revenue cycle leadership.

Qualifications

• Must have high school diploma or equivalent.
• Preferred: 3+ years medical coding experience.
• One coding certification from AAPC or AHIMA (CCA, CPC, CPB, CCS, CIC, COC, CCS-P).
• Meet all Employee Health Requirements.
• Experience with CPT, ICD-10-CM, ICD-10-PCS and risk adjustment guidelines.

Responsibilities

• Independently perform analysis of claims pre- and post-payment using CPT, ICD-10, and risk adjustment guidelines.
• Review medical records to validate or invalidate coding and billing issues.
• Develop and maintain an audit schedule in coordination with leadership and providers.
• Document findings to support claim adjustments with records and coding rationale.
• Identify process gaps contributing to incorrect payments.
• Ensure PHI confidentiality and security.
• Apply clinical and coding expertise for accurate documentation and claim submission.
• Collaborate with staff and Revenue Cycle leadership to resolve coding queries.

Skills

Critical thinking

Time management

Problem solving

Verbal communication

Written communication

Organization

EMR experience

Medical chart auditing

Medical terminology

Education

High School Diploma

Job description

The Certified Coder at Three Crosses Regional Hospital will code ICD-10-CM/ICD-10-PCS and CPT data for administrative and clinical records, ensuring compliance with federal and state regulations and hospital policies. The role requires high ethical standards and confidentiality.

Key duties include pre- and post-payment claim analysis, chart reviews, audit scheduling, documentation of findings, education of providers on coding practices, and collaboration with revenue cycle leadership.