What are the responsibilities and job description for the Medical Coder Specialist position at Heart City Health?
Position Summary: At Heart City Health, we seek a Medical Coder Specialist who helps ensure accurate and compliant coding of clinical encounters to support timely reimbursement and minimize denials. The coder is essential to help maintain financial sustainability, meet Uniform Data System (UDS) reporting requirements, and promote fair access to care. The coder specialist will collaborate closely with providers, the billing department team, and the compliance team to ensure the integrity of documentation and coding accuracy with payers. This will be achieved by reviewing medical records, assigning standardized codes using ICD-10 and CPT, and ensuring that patient records are accurate and complete.
Key Responsibilities:
- Review clinical documentation and assign appropriate ICD-10 and HCPC codes for medical and behavioral health.
- Ensure coding aligns with payer guidelines following FQHC rules and the encounter type.
- Query providers for clarification when documentation is incomplete or unclear.
- Work closely with the Billing team to resolve coding-related denials and rejections.
- Maintain knowledge of coding updates, payer policies, and FQHC-specific coding requirements.
- Participate in internal audits and contribute to provider education on documentation best practices.
Required Qualifications & Competencies:
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent required certification.
- High school diploma or equivalent required; associate degree or billing certification preferred.
- Experience in medical coding and billing.
- Strong knowledge of ICD-10, CPT, HCPCS, and modifiers.
- Familiarity with Medicaid, Medicare, and commercial payers' coding rules.
- Excellent attention to detail, analytical skills, and ability to work independently.
Physical Demands:
- May sit and/or stand for long periods of time
- Must be able to see and hear within normal range with or without correction device(s)
Dexterity and hand to eye coordination as normally associated with operating office equipment and computers.