Coder, Certified

Shenandoah Medical Center; Shenandoah (IA); On-site; USD 60,000 - 75,000; Full time

Job summary

Shenandoah Medical Center seeks a skilled medical coder and internal auditor to ensure accurate coding and sequencing of diagnoses and procedures for maximum reimbursement. You will review documentation, assign charge master codes and modifiers, and work across systems to match patient accounts with billable charges.

The role emphasizes audits, education, and ongoing compliance with coding standards, while collaborating with staff to resolve documentation gaps and optimize revenue integrity.

Qualifications

• ICD-10 CM/PCS, CPT-4, and HCPCS coding knowledge required or preferred.
• 3–5 years of internal auditing experience preferred.
• 1–3 years of medical coding experience preferred.

Responsibilities

• Accurately codes and sequences diagnoses and procedures for optimal reimbursement.
• Reviews documentation to determine diagnoses and procedures performed.
• Uses systems to assign charge master codes and modifiers.
• Participates in audits to capture lost charges and ensure accuracy.
• Maintains communication with staff and providers on documentation gaps.

Skills

Medical coding

Auditing

ICD-10 CM/PCS

CPT-4

HCPCS

Education

High School or better

Job description

1. Accurately codes and sequences diagnosis and procedures according to coding guidelines and abstract accurate clinical information for optimum reimbursement.

• Reviews documentation to determine the diagnosis and procedures performed.
• Assigns charge master codes, modifiers for appropriate billing and sequencing.
• Uses multiple information systems to accurately select the correct patient account to enter patient billable charges.
• Participates in audits to capture lost charges and determine accuracy of billing and coding.
• Maintains active contact with staff and providers on missing or inaccurate documentation.
• Maintains active contact with departments to resolve billing issues.
• Communicates and collaborates with healthcare providers/ compliance/coding on identifying changes in documentation that may lead to maximizing reimbursement.

2. Demonstrates professional growth by developing personal educational objectives to maintain coding knowledge and regulatory requirements and participating in opportunities to assure continued adherence to professional standards and the provision of highest quality care.

• Plans and implements a program for continuing self-development to meet continuing education requirements for CPC, COC, CCS, CCS-P certification.
• Demonstrates organizational skills, self-motivation and flexibility in meeting personal, professional and institutional objectives.
• Maintains current knowledge of national NCCI Coding standards of practice, JCAHO/CMS, and criteria appropriate to coding and billing.
• Maintains current knowledge of changes in ICD-10 CM/PCS, CPT-4 and HCPCS. Provide feedback and education on codes that are changed or no longer appropriate for billable items.
• Organizes data to allow for identification of documentation trends to provide feedback to staff and other healthcare providers to allow for increased capture of billable items.

3. Follows policies/procedures/regulatory requirements and performs other work assignments.

• Complies with all departmental and organizational policies and procedures in addition to regulatory requirements (such as OSHA, CMS, Joint Commission, etc.)
• Participates in corporate/departmental safety and quality activities.

4. Performs other duties as assigned.

Travel Required

No .

Qualifications

Education

Required

High School or better.

Experience

Preferred

3-5 years: internal auditing experience preferred

1-3 years: medical coding experience preferred (ICD-10 CM/PCS, CPT-4, HCPCS)

Equal Opportunity Employer
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