Job Title: Medical Coder (Med Coder/24/MCO400)
Location: Remote
Job Type: Full-Time (40 hours/week)
Work Schedule
- Monday through Friday during normal business hours
- Overtime may be required based on business needs
Position Summary
We are seeking an experienced Certified Medical Coder responsible for accurately assigning diagnosis, procedure, and modifier codes for professional services across multiple healthcare settings, including clinics, outpatient facilities, and inpatient facilities. The ideal candidate will have strong knowledge of medical coding guidelines, provider documentation, and Medicare Advantage Risk Adjustment (HCC) coding.
Key Responsibilities
- Accurately assign ICD-10-CM, CPT, HCPCS, and modifier codes based on provider documentation and medical records.
- Review and validate provider documentation to ensure accurate code assignment.
- Apply knowledge of diagnosis coding, procedural coding, evaluation and management (E/M), and ancillary services.
- Interpret clinical documentation using knowledge of anatomy, physiology, disease processes, and medical terminology.
- Identify incomplete or unclear documentation and generate provider queries for clarification.
- Follow up with providers to obtain timely responses to documentation queries.
- Utilize coding software and reference materials to determine appropriate medical codes.
- Apply provider responses to finalize coding determinations.
- Ensure compliance with federal, state, payer, and professional coding guidelines.
- Review and resolve coding edits, denials, and documentation discrepancies.
- Maintain productivity, accuracy, and turnaround time standards while managing multiple coding assignments.
- Respond to coding quality audits and provide supporting documentation as needed.
- Educate and mentor team members to improve coding quality and consistency.
- Demonstrate an understanding of the impact of coding on the revenue cycle.
- Perform additional duties as assigned.
Required Qualifications
- High School Diploma or GED (or higher).
- Minimum 3 years of professional medical coding experience, preferably within:
- Medicare Advantage
- Risk Adjustment/HCC Coding
Pride-Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, pet insurance and employee discounts with preferred vendors.
Equal Employment Opportunity
Pride-Health is an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.
Fair Chance Employment
Pride-Health is a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances.
Accommodations
We are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require a reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.
Only applicable for San Francisco Candidates: Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.
Only applicable for Kentucky positions: For this type of employment, state law requires a criminal record check as a condition of employment. This applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky nursing facilities, assisted living communities, or long-term care facilities, in accordance with KRS 216.793.
Company Description
Pride Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, pet insurance and employee discounts with preferred vendors.
Equal Employment Opportunity
Pride Health is an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.
Fair Chance Employment
Pride Health is a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances.
Accommodations
We are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require a reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.
Only applicable for San Francisco Candidates: Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.
Only applicable for Kentucky positions: For this type of employment, state law requires a criminal record check as a condition of employment. This applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky nursing facilities, assisted living communities, or long-term care facilities, in accordance with KRS 216.793.
