Medical Coder

Start Corporation; Houma (LA); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Disability insurance

Life insurance

Paid time off

13 paid holidays per year

403(b) retirement plan with employer-m

Job summary

Start Corporation is seeking an experienced Medical Coder to join our team in Louisiana. The role requires reviewing records, assigning ICD-10-CM, CPT, and HCPCS codes, and ensuring accurate coding reflecting services rendered.

Responsibilities include auditing documentation for medical necessity, supporting billing processes, and educating providers on coding changes. A strong background in E/M coding and payer policies is essential to maintain compliant, efficient revenue cycle operations.

Qualifications

• High school diploma or equivalent.
• 2-3 years of professional medical coding experience preferred.
• Completion of an accredited medical coding or medical billing and coding program preferred.
• Knowledge of ICD-10-CM, CPT, HCPCS, E/M coding, Medicare and Medicaid coding requirements, and medical necessity.
• Knowledge of medical terminology, anatomy, and healthcare documentation.
• Experience with electronic health records and healthcare billing systems preferred.
• Experience reviewing provider documentation and resolving coding discrepancies.

Responsibilities

• Review medical records and assign ICD-10-CM, CPT, and HCPCS codes based on documentation and services provided.
• Review and validate E/M coding and appropriate levels of service.
• Ensure coding reflects diagnoses, conditions, procedures, and services documented.
• Identify incomplete or conflicting documentation and communicate with providers for clarification.
• Review documentation for medical necessity and linkage between diagnoses and services.
• Apply CMS, Louisiana Medicaid, NCCI, and payer-specific coding guidelines.
• Maintain knowledge of annual coding and regulatory updates.
• Apply FQHC-specific billing and coding requirements and PPS reimbursement guidance.
• Review claims for proper FQHC billing methodology and payer requirements.
• Identify billable vs bundled services and ensure alignment with payer rules.
• Provide coding and documentation guidance to clinicians and staff.
• Assist with internal coding audits and corrective-action initiatives.
• Participate in provider education on CPT/ICD-10-CM/HCPCS changes.
• Collaborate with Billing, Revenue Cycle, HIM, and Compliance to resolve coding issues.
• Support risk adjustment and quality measures through accurate coding.

Skills

Medical coding knowledge

Analytical skills

Attention to detail

Effective communication

Confidentiality handling

Independent work

EHR & billing systems

Education

Accredited medical coding program

Tools

Electronic health records

Healthcare billing systems

Job description

About Start Corporation

Start Corporation is a 501(c)(3) non-profit organization founded in 1984. Our Mission is to promote opportunities, which enhance the self-sufficiency of people to empower them to live and function independently.

Job Description

We are looking for an experienced Medical Coder to join our team.

Minimum Requirements

• High school diploma or equivalent required.
• Minimum 2-3 years of professional medical coding experience preferred.
• Completion of an accredited medical coding or medical billing and coding program preferred.
• Demonstrated knowledge of ICD-10-CM, CPT, HCPCS, E/M coding, Medicare and Medicaid coding requirements, and medical necessity.
• Knowledge of medical terminology, anatomy, and healthcare documentation.
• Experience with electronic health records and healthcare billing systems preferred.
• Experience reviewing provider documentation and resolving coding discrepancies.

Core Competencies

• Ability to interpret payer policies, coding guidelines, and regulatory requirements.
• Strong analytical skills and attention to detail.
• Ability to communicate effectively with providers and administrative staff.
• Strong attention to detail and accuracy.
• Ability to maintain confidentiality and handle protected health information appropriately.
• Ability to work independently and meet established productivity and accuracy expectations.

Job Duties / Skills Required

Coding and Documentation Review

• Review medical records and assign appropriate ICD-10-CM, CPT, and HCPCS codes based on documentation and services provided.
• Review and validate E/M coding and appropriate levels of service.
• Ensure coding accurately reflects diagnoses, conditions addressed, procedures performed, and services documented.
• Identify incomplete, conflicting, or insufficient documentation and communicate with providers when clarification is necessary.
• Review documentation for medical necessity and appropriate linkage between diagnoses and services.
• Apply current CMS, Louisiana Medicaid, NCCI, and payer-specific coding guidelines.
• Maintain knowledge of annual and interim coding and regulatory updates.
  

FQHC/RHC Coding and Billing

• Apply FQHC-specific billing and coding requirements, including qualifying visits, encounter coding, and applicable HCPCS codes.
• Understand the relationship between professional coding and FQHC Prospective Payment System (PPS) reimbursement.
• Review claims for appropriate FQHC billing methodology and payer-specific requirements.
• Understand differences among Medicare, Louisiana Medicaid, Medicaid Managed Care, and commercial payer requirements.
• Identify services that are separately billable, bundled, incidental, or included within the FQHC encounter payment.
• Maintain familiarity with coding requirements for primary care, preventive care, behavioral health, psychiatry, substance use disorder treatment, and other services provided by START Corporation.

Claims Review and Denial Prevention

• Perform pre-bill and post-bill coding reviews as assigned.
• Review coding-related claim edits, denials, and rejections and recommend appropriate corrections.
• Assist Revenue Cycle staff with coding-related appeals, reconsiderations, and payer disputes.
• Identify recurring coding, documentation, or payer issues affecting reimbursement.
• Assist with root-cause analysis of coding-related denials and underpayments.
• Identify opportunities to improve clean-claim rates and reduce avoidable denials.
• Collaborate with Billing, Revenue Cycle, HIM, Compliance, clinical leadership, and providers to resolve coding issues.

Provider Education and Compliance

• Provide coding and documentation guidance to physicians, nurse practitioners, physician assistants, behavioral health professionals, and other clinical staff.
• Educate providers regarding documentation requirements necessary to support billed services.
• Communicate coding concerns professionally and provide supporting regulatory or coding guidance.
• Assist with internal coding audits and corrective-action initiatives.
• Participate in provider education regarding CPT, ICD-10-CM, HCPCS, CMS, Louisiana Medicaid, and payer changes.
• Identify potential compliance concerns and appropriately elevate findings.
• Maintain documentation supporting coding decisions and audit findings.

Quality and Value-Based Care Support

• Assist with accurate diagnosis coding related to risk adjustment and value-based care initiatives.
• Review documentation for appropriate capture of chronic conditions addressed during encounters.
• Support coding accuracy related to quality measures and preventive services.
• Collaborate with clinical and quality teams to improve documentation and coding accuracy while ensuring all reported diagnoses and services are supported by the medical record.

Benefits include: Medical, dental, and vision insurance; disability and life insurance; paid time off; 13 paid holidays per year for regular full-time employees; and a 403(b) retirement plan with employer matching.