Coder - Insurance/Billing/Chart Review

Agence PROvidence; Anaheim (CA); On-site; USD 65,000 - 90,000; Full time

Job summary

Providence Medical Foundation is seeking a coding auditor to review patient care billing documentation for CPT/ICD alignment with federal, state, and payer policies. The role supports the broader provider network performance mission and requires strong coding credentials and billing experience.

The ideal candidate will hold AHIMA/AAPC certifications or equivalent, have several years of diverse coding experience, and be proficient with Microsoft Office to facilitate reporting and documentation.

Qualifications

• Associate's Degree in Coding education or AHIMA/AAPC certification program, or work experience in medical offices.
• National Certification from AAPC or AHIMA upon hire.
• National Certification like CCS, CDIP, CHIA, RHIA/RHIT preferred.
• 3 years Professional Coding experience across specialties (HCC, Primary Care, Oncology, Infusion, Neurology, OB/GYN, Cardiology, Endocrinology, Rheumatology, General Surgery).
• 3 years Physician/clinic billing experience.
• Experience with Microsoft Office (Word, Excel, Outlook).

Responsibilities

• Perform coding audits of patient care billing documentation to ensure CPT/ICD guideline adherence and payer policy.

Skills

CPT & ICD coding

Coding auditing

Healthcare billing experience

MS Office (Word/Excel/Outlook)

Education

Associate's Degree in Coding education or AHIMA/AAPC certification program

CPC/CCS/CDIP/AHIMA/AAHIMA certifications

Tools

Microsoft Office

Job description

Under direction of the Director Provider Network Performance, performs coding audits of patient care billing documentation to ensure adherence with CPT and ICD coding guidelines and federal, state, and commercial payor billing and payment policy for all services provided by Providence Medical Foundation.

Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we Providence know that to inspire and retain the best people, we must empower them.

Required qualifications:

• Associate's Degree in Coding education in college setting or certified distance learning program such as that provided by AHIMA or AAPC. Or Work experience in medical offices (insurance, coding, billing, registration duties).


• Upon hire: National Certification from American Academy of Professional Coders. Or


• Upon hire: National Certified Coding Associate - American Health Information Management Association.


• Upon hire: National Certified Coding Specialist - American Health Information Management Association.


• Upon hire: National Certified Coding Specialist - Physician - American Health Information Management Association.


• Upon hire: National Certified Documentation Improvement Practitioner - American Health Information Management Association.


• Upon hire: National Certified Health Data Analyst - American Health Information Management Association.


• Upon hire: National Registered Health Information Administrator - American Health Information Management Association.


• Upon hire: National Registered Health Information Technician - American Health Information Management Association


• 3 years Professional (POS11) Coding experience in HCC coding, Primary Care, Oncology, Infusion, Neurology, OB/GYN, Cardiology, Endocrinology, Rheumatology, General Surgery.


• 3 years Physician/clinic billing experience.


• Experience with Microsoft Office (Word, Excel, Outlook)

Preferred qualifications:

• Upon hire: Additional certifications (specialty coding certifications)


• Upon hire: Medical billing and coding certificate

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.