Physician Billing Certified Coder I

Valley Children's Healthcare; California; On-site; USD 42,000 - 62,000; Full time

Job summary

Valley Children’s Healthcare is seeking a Certified coder I to join our billing team. The coder reviews provider documentation, ensures accurate CPT/ICD-10 coding, and supports the professional billing workflow including claim edits, processing, rejections, data entry, and queries.

This role communicates with physicians on documentation issues and drafts letters to coordinate appeals as needed. The ideal candidate has a CPC certification, 2+ years of related experience, and strong knowledge of

Qualifications

• CPC certification required for consideration.
• Minimum 2 years related experience.
• Strong CPT/ICD-10 coding knowledge and professional billing workflow.
• Ability to communicate with physicians to resolve coding issues.

Responsibilities

• Review provider documentation for accurate CPT/ICD-10 coding.
• Perform coding, claim edits, processing, and data entry as needed.
• Handle queries and communicate documentation concerns to physicians.
• Draft letters to coordinate appeals and address billing variances.

Skills

Independent work

Multitasking

Medical terminology

Anatomy knowledge

CPT/ICD-10 coding

Education

High School Diploma/G.E.D. (required)

CPC - Certified Professional Coder - AAPC (required)

Job description

Job Summary:

The Certified coder I is responsible for properly reviewing provider documentation and can perform all coding functions. Possesses a solid understanding of the professional billing workflow and assists with general billing duties as necessary to include claim edits, claims processing, claim rejections, data entry, and queries and communicates with physicians on documentation issues related to code assignment and provides feedback to physicians and the physician billing entity on variances between hospital and physician CPT coding as needed. Helps identify and resolve incorrect claims issues and is responsible for drafting letters to coordinate appeals as well as other areas related to billing as assigned by the manager.

Qualifications

Education

• High School Diploma/G.E.D. (required)

Licenses and Certifications

• CPC - Certified Professional Coder - AAPC - American Academy of Professional Coders (required)

Work Experience

• Minimum two (2) years Related experience or RHIT certificate (preferred)
• Minimum two (2) years ICD-10 CM/PCS and CPT-4 coding experience with outpatient surgery medical records. (preferred)
• Minimum one (1) year Anesthesiology coding experience (preferred)

Skills and Abilities

• Ability to work independently with limited supervision.Skilled in gathering and reporting information.Ability to multi-task and prioritize needs in order to meet timelines. Knowledge of medical terminology and anatomy. Knowledge of CPT, ICD-10, ASA and HCPCS coding.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Compensation Range:

$30.82 - $44.80

Position Exempt:

No

FTE %:

100

Scheduled Weekly Hours:

40

Daily Hours:

8