Certified Professional Coder

Lyndon Baines Johnson Tropical Medical Center; Tafuna (AS); On-site; USD 28,000 - 50,000; Full time

Job summary

LBJ Tropical Medical Center in American Samoa is seeking a Certified Professional Coder (CPC) to assign CPT®, HCPCS Level II and ICD-10-CM codes for professional services in accordance with CMS regulations and payer guidelines.

The CPC ensures documentation supports all reported services, maintains coding integrity, reduces denials, and assists with audits. Qualifications include an active CPC credential, knowledge of EHR coding software, and experience with Medicare/Medicaid billing.

Qualifications

• Active CPC credential from AAPC or equivalent professional coding certification.
• High School Diploma or equivalent.
• Knowledge of CPT coding, HCPCS Level II coding, ICD-10-CM diagnosis coding.
• Medicare and Medicaid professional billing requirements and CMS regulations.
• NCCI edits, Global Surgical Package rules, modifier usage guidance.

Responsibilities

• Review physician documentation to assign CPT, HCPCS Level II, and ICD-10-CM codes.
• Ensure compliance with coding and billing requirements across payer guidelines.
• Support audits and respond to denials with accurate coding edits.
• Maintain confidentiality and HIPAA compliance.
• Stay current with coding updates and regulatory changes.

Skills

CPT coding

HCPCS Level II coding

ICD-10-CM coding

CMS regulations

NCCI edits

Modifier usage

Documentation review

Education

CPC credential (AAPC)

High School Diploma

Associate degree in Health Information Management

Tools

EHR systems

Coding software

Billing applications

Job description

LBJ TROPICAL MEDICAL CENTER

EMPLOYMENT OPPORTUNITY

September 11, 2026

The Department of Human Resources is accepting applications for the following position.

Job Title: Certified Professional Coder

Department: Business Affairs & Audits

Reports to: Chief of Business Affairs & Audits

Salary: $28,332.53 – $49,681.27

Position Summary

The Certified Professional Coder (CPC) is responsible for the accurate and compliant assignment of CPT®, HCPCS Level II, and ICD-10-CM diagnosis codes for professional services in accordance with CMS regulations, payer guidelines, and official coding standards.

The CPC ensures clinical documentation supports all reported services and diagnoses, contributing to accurate reimbursement, reduced denials, audit readiness, and regulatory compliance.

Professional Coding Responsibilities

• Review physician and qualified healthcare provider documentation to accurately assign:
  • CPT® codes
  • HCPCS Level II codes
  • ICD-10-CM diagnosis codes
• Ensure compliance with all applicable coding and billing rules, regulations, and requirements, including:
  • CMS National Correct Coding Initiative (NCCI)
  • CPT® guidelines
  • ICD-10-CM Official Guidelines for Coding and Reporting
  • Global Surgical Package rules
  • Unbundling regulations
  • Medically Unlikely Edits (MUEs)
  • Appropriate modifier usage (e.g., -25, -26, -TC, -59, XE, XP, XS, XU) as supported by documentation

Documentation Review & Compliance

• Verify documentation supports:
  • Level of service (E/M)
  • Procedures performed
  • Diagnoses reported
• Identify documentation deficiencies and collaborate with providers and Clinical Documentation Integrity (CDI) staff to obtain clarification as appropriate.
• Ensure compliance with payer-specific billing requirements, coverage determinations, and medical necessity guidelines.
• Maintain coding integrity and adherence to regulatory requirements.

Denials & Appeals Management

• Collaborate with Billing, Compliance, and Revenue Cycle teams to:
  • Reduce coding-related denials
  • Correct coding edits and claim rejections
  • Resolve billing discrepancies
• Review payer feedback and coding edits to identify trends and opportunities for process improvement.
• Support appeals, audit responses, and claim rework associated with professional services.
• Manage and resolve professional coding edits in a timely manner.

Audit & Education Support

• Participate in internal and external audits as directed by the Chief of Business Affairs & Audits (CBA&A), including:
  • CMS audits
  • Medicaid audits
  • Commercial payer audits
• Maintain organizational productivity and coding accuracy standards.
• Assist with provider education related to documentation requirements, coding regulations, and compliance standards.
• Stay current with coding updates, CMS regulations, and payer policy changes.

Systems & Workflow

• Utilize Electronic Health Record (EHR) systems, coding software, and billing applications to complete coding assignments.
• Maintain confidentiality and security of Protected Health Information (PHI) in accordance with HIPAA regulations.
• Adhere to hospital policies, coding standards, compliance requirements, and ethical coding practices.

Qualifications

Required Qualifications

Education & Certification

• Active Certified Professional Coder (CPC) credential from AAPC or equivalent professional coding certification.
• High School Diploma or equivalent.

Knowledge & Experience

Strong knowledge of:

• CPT® coding
• HCPCS Level II coding
• ICD-10-CM diagnosis coding
• Medicare and Medicaid professional billing requirements
• CMS regulations and payer-specific coding guidelines
• NCCI edits
• Global Surgical Package rules
• Modifier usage and documentation requirements
• Medically Unlikely Edits (MUEs)

Ability to:

• Interpret clinical documentation accurately
• Understand medical terminology, anatomy, and disease processes
• Apply coding regulations and reimbursement guidelines appropriately

Preferred Qualifications

• Associate degree or higher in:
  • Health Information Management
  • Healthcare Administration
  • Medical Coding
  • Related healthcare field
• Prior hospital or hospital-owned clinic professional coding experience.

Experience With:

• Medicare and Medicaid reimbursement
• Evaluation and Management (E/M) coding:
  • Office visits
  • Outpatient services
  • Emergency Department services
• Audit response activities
• Denial management and appeals

Additional Certifications Preferred

• Certified Outpatient Coder (COC)
• Certified Professional Medical Auditor (CPMA)
• Other relevant coding and compliance certifications

Skills & Competencies

• Strong attention to detail and accuracy
• Analytical and critical-thinking skills
• Ability to meet productivity and quality benchmarks
• Excellent written and verbal communication skills
• Strong organizational and time-management abilities
• Ability to work independently and collaboratively within a team environment
• Proficiency in EHR systems, coding software, and billing applications
• Commitment to ethical coding practices and compliance standards

Work Environment

• Office-based or remote work environment, as applicable
• Primarily computer-based work requiring extended periods of sitting
• Frequent interaction with:
  • Providers
  • Billing staff
  • Compliance personnel
  • Revenue Cycle teams
  • Organizational leadership

Deadline for filing applications with the LBJ Office of Human Resources will be at October 2 2026 @ 4:00 pm. Application forms are available at the Office of Human Resources.