Medical Coder - CPC

Medical Coder – Multi-Specialty

Position Summary

The Medical Coder is responsible for accurately reviewing clinical documentation and assigning appropriate diagnosis and procedure codes to ensure compliant billing and maximum appropriate reimbursement. This position requires strong multi-specialty coding experience, attention to detail, and a thorough understanding of coding guidelines, modifiers, and payer requirements.

Key Responsibilities

• Review provider documentation and medical records for accurate and complete coding.
• Assign appropriate ICD-10-CM, CPT, and HCPCS codes based on services documented.
• Apply appropriate modifiers and understand modifier-specific billing requirements.
• Code across multiple specialties and service types.
• Review provider notes to ensure documentation supports the codes and level of service billed.
• Identify missing, incomplete, or conflicting documentation and communicate with providers when clarification is needed.
• Ensure correct coding of E/M services, procedures, diagnostic testing, and other billable services.
• Understand and apply NCCI edits, bundling/unbundling rules, global periods, and medical necessity requirements.
• Review coding-related claim rejections and denials and make necessary corrections.
• Maintain familiarity with Medicare, Medicaid, Managed Care, and Commercial payer coding requirements.
• Ensure appropriate use of diagnosis-to-procedure code relationships and sequencing.
• Identify coding opportunities while ensuring all coding is fully supported by the medical record.
• Stay current with annual and ongoing changes to CPT, ICD-10, HCPCS, CMS, and payer guidelines.
• Work closely with billing and RCM teams to resolve coding-related issues and maximize clean claim submission.
• Maintain productivity and accuracy standards while managing a high volume of encounters.
• Follow HIPAA, compliance, and all applicable coding regulations.

Qualifications

• 2 years of professional medical coding experience required.
• Multi-specialty coding experience required.
• Strong knowledge of CPT, ICD-10-CM, HCPCS, and modifiers.
• Strong understanding of medical terminology, anatomy, and clinical documentation.
• Experience reviewing and interpreting provider notes and medical records.
• Familiarity with Medicare, Medicaid, and commercial insurance guidelines.
• Knowledge of coding edits, medical necessity, bundling rules, and payer-specific requirements.
• Experience with EMR/Practice Management systems.
• Strong attention to detail, accuracy, productivity, and problem-solving skills.
• CPC, CCS, CCA, or other recognized coding certification preferred.