Senior Medical Coder - ICD10/CPT-4 Expert

Jobtailor; Seattle (WA); On-site; USD 65,000 - 90,000; Full time

Job summary

Jobtailor in Seattle is seeking an experienced medical coder to review and code medical records with ICD-10, CPT-4, and HCPCS guidelines, ensuring compliance with government and payer requirements.

You will help providers with documentation questions, stay current on Medicare/NCCI guidelines, and address claim edits, denials, and trends to improve coding accuracy.

Qualifications

• Minimum 3 years coding/medical billing experience.
• Professional coder certification with AHIMA and/or AAPC, must be maintained annually.
• ICD10 certified and/or extensive work experience.

Responsibilities

• Review and interpret medical records to assign ICD10, CPT-4, and HCPCS codes.
• Follow up with providers for documentation that is insufficient, missing, or unclear.
• Assist providers with coding questions and communicate guidelines and trends to leadership.
• Keeps up to date on carrier policies/guidelines to ensure all coded services meet Medicare/NCCI or payer guidelines.
• Reviews and resolves suspended charges due to claim edits or payer rejections related to coding.
• Reviews, corrects and appeals coding-related denials and shares findings for root cause analysis and process improvement.
• Corrects and/or appeals denied claims due to coding errors.

Skills

ICD10 Coding

CPT-4 Coding

HCPCS Coding

Medical Billing

Denial Resolution

Education & Feedback

Education

AHIMA Certification

AAPC Certification

ICD10 Certification

Professional Coder Certification

Tools

Coding Software

Documentation Review Tools

Claim Edits System

Job description

• Reviews/audits and interprets medical record documentation to identify pertinent diagnosis/procedure and apply correct ICD10, CPT-4, and HCPC’s codes in accordance with government and insurance regulations.
• Demonstrates appropriate utilization of coding software and coding reference material.
• Follow up with providers on any documentation that is insufficient, missing, or unclear.
• Assists providers with questions regarding coding and documentation guidelines. Provides ongoing feedback based on observations from coding documentation and identifies opportunities for education and communicates trends to leaders.
• Keeps up to date on carrier policies/guidelines to ensure all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or Payer-specific guidelines.
• Reviews and resolves suspended charges due to claim edits or payor rejections related to coding.
• Reviews, corrects and appeals coding-related denials trends and shares with leadership, and team members to facilitate root cause analysis and continuous process improvement.
• Corrects and/or appeals denied claims due to coding errors
• Other duties as assigned

Requirements

• Minimum 3 years coding/medical billing experience
• Professional coder certification with credentialing from AHIMA and/or AAPC, must be maintained annually
• ICD10 certified and/or extensive work experience

Core Competencies

Expertise in medical coding and billing, including proficiency in ICD10, CPT-4, and HCPC's coding standards. Strong ability to analyze medical documentation, resolve coding-related denials, and provide education to healthcare providers on coding guidelines.

Highest-signal resume keywords

• ICD10 Coding
• CPT-4 Coding
• HCPC's Coding
• Professional Coder Certification
• Medical Billing Experience

ATS Optimization Keywords

Hard Skills

• Medical Record Documentation Review
• Coding Software Utilization
• Claim Denial Resolution
• Coding Guidelines Interpretation
• Root Cause Analysis

Soft Skills

• Communication
• Feedback Provision
• Education Facilitation

Certifications & Qualifications

• AHIMA Certification
• AAPC Certification
• ICD10 Certification

Industry Keywords

• Medicare Guidelines
• National Correct Coding Initiative
• Payer-Specific Guidelines
• Coding Documentation Trends