The Medical Billing Coder I reviews, analyzes, and codes patient medical documentation to support accurate billing, reimbursement, and regulatory compliance.
This role translates clinical documentation into standardized medical codes and ensures claims are complete, accurate, and supported by appropriate documentation before submission.
The position plays an important part in reducing claim denials, improving revenue cycle performance, and ensuring patients are billed appropriately according to payer and government guidelines.
The role also collaborates with providers, claim resolution specialists, insurance representatives, and clinic staff to resolve coding issues, improve documentation quality, and support timely reimbursement.
Key responsibilities include:
- Review assigned claims to ensure accurate coding and claim submission prior to billing
- Assign ICD-10-CM, CPT, and HCPCS codes based on provider documentation, clinical notes, and electronic medical records
- Abstract and compile documentation and claim data needed for reimbursement
- Ensure codes support medical necessity requirements
- Review claims for missing, incomplete, vague, or inconsistent documentation and request clarification when needed
- Complete coding corrections, billing adjustments, rebill requests, and claim updates
- Sequence codes according to payer, government, and organizational requirements
- Review denied or rejected claims to identify root causes and corrective actions
- Research payer requirements and communicate with insurance representatives about claim denials and reimbursement issues
- Request and upload supporting documentation to patient accounts and payer systems
- Validate payer information and verify patient eligibility when applicable
- Identify documentation deficiencies and communicate concerns to providers and staff
- Monitor coding edits, payer trends, and denial patterns to support process improvement
- Support workflow improvements, SOP development, visual aids, and coding process enhancements
- Collaborate with leadership, clinic staff, and claim resolution specialists to resolve coding and reimbursement issues
- Maintain compliance with HIPAA, Medicare, Medicaid, commercial payer requirements, and organizational policies
Required qualifications:
- High school diploma or GED equivalent
- Minimum 1 year of experience in medical billing, coding, accounts receivable, denial resolution, or related healthcare revenue cycle functions
- CPC-A certification required within 2 years of employment
- Experience using EMR/EHR systems; EPIC experience preferred
- Proficiency with Microsoft Office applications
- Experience navigating insurance web portals
- Accurate typing and data entry skills
- Basic knowledge of ICD-10-CM, CPT, HCPCS, medical terminology, anatomy, and payer guidelines
Preferred qualifications:
- Prior coding experience in Medicare, Medicaid, commercial, private, or OB specialties
- Experience working in Federally Qualified Health Centers (FQHCs) or healthcare clinic environments
- Additional coding certifications preferred
Working conditions:
- Office-based environment
- Prolonged sitting and computer use
- Frequent keyboarding and repetitive hand motions
- Frequent visual concentration and attention to detail
- Ability to maintain concentration in a fast-paced environment
- Ability to communicate effectively verbally and in writing
- Occasional lifting up to 25 pounds
Location
Oklahoma City, Oklahoma, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
2 weeks ago