Senior Certified Medical Coder, Claims

Job Description

Job Description:

We are seeking a detail-oriented and experienced Senior Certified Medical Coder to join our client's Claims team. This dual-role position is responsible for ensuring accurate medical coding and efficient claims processing to support timely reimbursement and regulatory compliance. The ideal candidate will have a strong background in medical coding, claims adjudication, and healthcare administration. 

Compensation:

• $50,000 - $60,000/year (based on experience)
• 4 weeks of PTO + 9 company holidays
• 401(k) with generous company match
• Full medical benefits

Requirements:

• Education: Associate’s or Bachelor’s degree in Health Information Management, Healthcare Administration, or related field.
• Certifications: CPC, CCS, or equivalent medical coding certification required.
• Experience: Minimum 5 years of experience in medical coding and claims processing, preferably in a senior or lead role.
• Strong knowledge of medical terminology, anatomy, and healthcare reimbursement systems.
• Proficiency with EHR systems and claims management software (e.g., Epic, Cerner, Availity).
• Excellent analytical, organizational, and communication skills.

Key Responsibilities:

• Review and analyze medical records to assign accurate ICD-10, CPT, and HCPCS codes.
• Submit, track, and follow up on insurance claims to ensure timely and accurate reimbursement.
• Investigate and resolve claim denials, discrepancies, and appeals.
• Collaborate with providers, billing staff, and insurance companies to clarify documentation and coding issues.
• Maintain up-to-date knowledge of payer policies, coding guidelines, and regulatory changes.
• Generate reports on claims status, coding accuracy, and reimbursement trends.
• Mentor junior staff and assist with training on coding and claims procedures.

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