Medical Coder

Start Corporation; Houma (LA); On-site; USD 52,000 - 72,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Disability insurance

Life insurance

Paid time off

13 paid holidays

403(b) retirement plan with employer匹

Job summary

Start Corporation in Louisiana seeks an experienced Medical Coder to join our nonprofit team dedicated to improving community health services. You will review records, assign ICD-10-CM, CPT, and HCPCS codes, and ensure proper coding reflects clinical documentation and payer requirements.

The role involves coordinating with providers and the Revenue Cycle team to resolve discrepancies, ensure medical necessity, and maintain compliance with CMS and state guidelines.

Qualifications

• High school diploma or equivalent required.
• 2–3 years of professional medical coding experience preferred.
• 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 accurately reflects diagnoses, conditions addressed, procedures performed, and services documented.
• Identify incomplete or conflicting documentation and request clarification from providers.
• 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 and interim coding updates.
• Apply FQHC-specific billing and coding requirements; review claims for PPS reimbursement.
• Understand Medicare, Louisiana Medicaid, Medicaid Managed Care, and commercial payer requirements.
• Identify services that are separately billable, bundled, incidental, or included in FQHC payments.
• Maintain familiarity with coding requirements for primary care, preventive care, behavioral health, psychiatry, substance use disorder treatment, and other START Corporation services.
• Perform pre-bill and post-bill coding reviews; review claim edits, denials, and rejections; assist with appeals.
• Identify opportunities to improve clean-claim rates and reduce denials; collaborate with Billing, Revenue Cycle, HIM, Compliance, and providers.

Skills

Medical coding

ICD-10-CM

CPT

HCPCS

E/M coding

Medicare/Medicaid

Medical terminology

Anatomy

EHR systems

Billing systems

Documentation review

Payer policies

Communication with providers

Attention to detail

Confidentiality

Productivity

Education

Medical coding program

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.