We are recruiting for a Medical Billing Coder to join a healthcare organization in Sacramento. This is a direct hire opportunity, and our client offers a generous benefits package, with 90% health coverage for the employee, 401k plus employer match, and remote work schedule after training. The Medical Coder will be responsible for managing day-to-day coding and billing operations.  Pay: $27-$32/hour DOE. 

The ideal candidate will have expertise in coding guidelines and medical billing processes, with proficiency in Epic and CPC certification.

RESPONSIBILITIES: 

• Coding & Billing: Review and adjudicate coding of services from documentation in a timely manner.

• Procedure Coding: Code physician/provider visit procedure notes to identify appropriate ICD-10 and CPT-4 codes for charge processing.

• Code Optimization: Ensure that all diagnosis ICD-10 codes and procedure CPT, HCPCS codes are identified, sequenced, and coded accurately and ethically for optimized reimbursement.

• E&M Coding: Assign Evaluation and Management codes based on key documented concepts/elements, adhering to defined coding guidelines.

• Research: Identify correct codes for routine, new, or unusual diagnoses and procedures not clearly listed in ICD-10 and CPT guidelines.

• Modifier Identification: Identify procedures requiring modifiers (including 340B) for billing and reporting.

• Provider Education: Collaborate with the Billing Supervisor to provide coding guideline education to providers.

• Clinical Data Consultation: Consult with physicians and providers for clarification of clinical data when encountering conflicting or ambiguous information and/or significant missing documentation.

• Documentation Tracking: Track cases with insufficient documentation to ensure they become appropriately coded and billed.

• Policy Adherence: Ensure documentation adheres to Federal, State, and County billing policies.

SKILLS & QUALIFICATIONS:

• Minimum 2 years of experience in medical coding.

• High school diploma or equivalent required.

• Current CPC certification through AAPC or AHIMA required.

• Comprehensive knowledge and understanding of medical coding, including insurance payor guidelines, ICD-1O, CPT Billing, and E/M coding.

• Ability to analyze medical records in an Electronic Health Record system to identify documentation deficiencies and verify documentation supports diagnoses, procedures, and treatments.

• Epic experience preferred.