Certified Professional Coder (CPC)
Posted: 06/01/2026
Job Number: 162
Job Description
The Certified Professional Coder (CPC) is responsible for reviewing clinical documentation and accurately assigning diagnosis and procedure codes for healthcare providers across multiple client organizations. This role ensures coding compliance with federal regulations, payer requirements, and industry standards while supporting optimal reimbursement and minimizing claim denials.
The ideal candidate is detail-oriented, knowledgeable in medical coding guidelines, and experienced working with multiple specialties and provider groups in a fast-paced medical billing environment.
Key Responsibilities Medical Coding
- Review medical records, encounter notes, operative reports, and supporting documentation to assign accurate ICD-10-CM, CPT, and HCPCS codes.
- Ensure coding accuracy and compliance with payer-specific requirements, industry regulations, and coding guidelines.
- Analyze provider documentation to determine appropriate code selection and level of service.
- Identify documentation deficiencies and communicate with providers and clients to obtain necessary clarification.
- Apply coding updates, modifiers, and regulatory changes as required.
- Maintain compliance with coding regulations, including CMS, Medicare, Medicaid, commercial payer, and industry standards.
- Conduct coding audits and reviews to identify errors, trends, and opportunities for improvement.
- Assist in the development and implementation of coding policies and procedures.
- Monitor coding quality metrics and support corrective action initiatives when necessary.
- Stay current on coding updates, reimbursement changes, and regulatory requirements.
- Support multiple healthcare clients across various specialties and practice settings.
- Provide coding guidance and education to providers, practice staff, and internal teams.
- Respond to coding-related inquiries and assist with claim resolution efforts.
- Collaborate with credentialing, billing, accounts receivable, and client success teams to improve reimbursement outcomes.
- Review denied claims and identify coding-related issues affecting reimbursement.
- Recommend coding corrections and resubmission strategies when appropriate.
- Assist with payer audits, appeals, and documentation requests.
- Work closely with billing teams to reduce coding-related denials and improve clean claim rates.
- Maintain coding productivity and accuracy standards.
- Generate coding reports and track key performance indicators.
- Identify trends impacting reimbursement, compliance, and operational efficiency.
- Participate in workflow improvement initiatives to enhance coding processes and client outcomes.
- Current Certified Professional Coder (CPC) certification through the American Academy of Professional Coders (AAPC).
- Minimum of 2 years of professional medical coding experience.
- Strong knowledge of ICD-10-CM, CPT, and HCPCS coding systems.
- Experience coding for physician practices, outpatient services, or multi-specialty healthcare organizations.
- Knowledge of Medicare, Medicaid, and commercial payer reimbursement methodologies.
- Ability to interpret medical documentation and apply coding guidelines accurately.
- Proficiency with Electronic Health Records (EHRs), practice management systems, and billing software.
- Strong analytical and problem-solving skills.
- Excellent written and verbal communication abilities.
- Experience working in a medical billing company or revenue cycle management environment.
- Multi-specialty coding experience.
- Additional coding certifications such as CPC-I, CPMA, COC, CRC, or CCS.
- Experience conducting coding audits and provider education.
- Familiarity with payer audits, appeals, and compliance programs.
- Exceptional attention to detail and accuracy.
- Strong understanding of healthcare reimbursement methodologies.
- Ability to manage multiple client accounts and priorities simultaneously.
- Critical thinking and analytical skills.
- Effective communication and provider education abilities.
- Commitment to confidentiality and HIPAA compliance.
- Ability to work independently while contributing to a collaborative team environment.