Certified Professional Coder, PAM

Duncan Regional Hospital; Duncan (OK); On-site; USD 48,000 - 64,000; Full time

Job summary

Duncan Regional Hospital in Duncan, OK, seeks a Full-Time Medical Coder to review patient records after clinics, assign ICD-10-CM, CPT, and HCPCS codes, and prepare claims for insurers. The role requires attention to detail and knowledge of coding guidelines, with responsibilities spanning verification, documentation checks, and billing accuracy.

The coder will interact with clinical staff to resolve ambiguities, ensure medical necessity, and maintain compliance with coding standards.

Qualifications

• Minimum: High school diploma or equivalent; CPC/CCS/CMC or similar certifications preferred.
• Proven knowledge of CPT and ICD-10 coding policies and guidelines.

Responsibilities

• Assigns and sequences ICD-10-CM, CPT, HCPCS codes per guidelines and regulations.
• Ensures correct CPT/ICD-10 coding and sequencing for government and insurer requirements.
• Queries providers when documentation is unclear or insufficient for coding.
• Enters charges such as E/M levels, infusions, injections, and observation hours.
• Participates in ongoing coding education to stay updated on guidelines and reporting requirements.
• Identifies and reports discrepancies or billing issues.
• Reviews records to ensure documentation supports services and medical necessity.
• Adheres to Ethical Coding standards and secure handling of confidential records.
• Performs other related duties as assigned.

Skills

ICD-10-CM coding

CPT coding

HCPCS

EHR systems

Medical terminology

Communication skills

Attention to detail

English proficiency

Documentation review

Billing compliance

Education

High school diploma or equivalent

Tools

Electronic Health Record (EHR) software

Job description

Job Details

Job Location: DRH Business Center (CBO and CWS) - Duncan, OK 73533

Position Type: Full Time

Education Level: Certification

Travel Percentage: None

Job Shift: Day Shift

Job Category: Administrative

JOB SUMMARY:

This position is responsible for reviewing a patient’s medical records after a Clinic visit and translating the information into codes that insurers use to process claims for patients. Duties include confirming treatments with medical staff, identifying missing information, and submitting information to insurers for reimbursement.

RESPONSIBILITIES (ESSENTIAL FUNCTIONS):

• Accurately assigns and sequences codes (ICD-10-CM, CPT, HCPCS/modifiers as necessary) for each patient encounter, following proper coding guidelines and legal requirements to ensure compliance with federal and state regulations.
• Ensures professional/physician billing CPT codes/ICD-10 codes are assigned correctly and sequenced appropriately as per government and insurance regulations.
• Queries providers or other Clinic team members when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes.
• Assigns and enters charges such as evaluation and management (E&M) levels, infusion/injections, observation hours, etc.
• Participate in continuing education activities to expand coding skills and stay abreast of changes in coding guidelines and reimbursement reporting requirements.
• Identifies and reports discrepancies, potential quality concerns, and billing issues.
• Reviews records to ensure documentation in the record supports ordered services and meets medical necessity.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Association and adheres to official coding guidelines.
• Distribute confidential and sensitive information or documentation; Handle highly confidential records. Ensure records are safe and secure at all times.
• Regular attendance and punctuality for scheduled shifts.
• Maintains professional and technical knowledge through continuing education opportunities including internal and external educational offerings.
• Utilization of assistive devices for lifting is mandatory.
• Must adhere to safety protocols at all times.
• Per DRH policy, all required conditions of employment must be met and maintained including required vaccinations.
• Implement DRH Standards of Behavior and exhibit behaviors consistent with DRH core values.
• Performs other related duties as assigned.

Qualifications

JOB REQUIREMENTS:

Minimum Qualifications: Communication and interpersonal skills including fluency in oral and written English. Basic computer skills including the ability to send/receive/email, navigate information technology associated with the position, and use Electronic Health Record information tools. Strong attention to detail with excellent organizational skills. Ability to adapt procedures, processes, tools, equipment, and techniques to accomplish the requirements of the position.

Education and/or Experience: High school diploma or equivalent required. At least 2 years of progressively responsible experience in medical insurance, medical billing, or medical reimbursement preferred.

Proven knowledge of CPT and ICD-10 coverage policies, coding guidelines, internal revenue cycle coding processes, and billing practices of the specialty service line. Demonstrated ability to read and interpret E&M notes, complex diagnostic study results, endoscopic, interventional and/or procedure operative notes. Based on documentation review, demonstrated ability to confirm or change the billed CPT code(s), diagnosis code(s) and modifiers (if applicable) in order to attain clean claim result. Strong knowledge of the carrier coverage policies and documentation requirements for specialty specific service lines. Ability to work independently and remain flexible to quickly adapt to urgent situation.

Certifications, Licenses, Registrations: Certified Professional Coder (CPC), Certified Medical Coder (CMC), Certified Coding Specialist (CCS), Certified Coding Associate (CCA), or Certified Professional Auditor (CMPA) or equivalent required; May have up to 6 months to obtain after date of hire or transfer. For those positions requiring travel, a current valid driver’s license and automobile liability insurance must be maintained.