Certified Professional Coder

About the Role: The Certified Professional Coder (CPC) plays a critical role in the healthcare industry by accurately translating medical diagnoses, procedures, and services into standardized codes used for billing and record-keeping. This position ensures that healthcare providers receive proper reimbursement from insurance companies and government programs by applying precise coding guidelines and regulations. The CPC collaborates closely with healthcare professionals to review clinical documentation, clarify ambiguities, and maintain compliance with coding standards. By maintaining up-to-date knowledge of coding systems such as ICD-10, CPT, and HCPCS, the coder supports the integrity and efficiency of the revenue cycle management process. Ultimately, this role contributes to the financial health of medical practices while safeguarding patient data confidentiality and regulatory compliance. Candidates are required to reside in Colorado and may be required to attend in office meetings. Onsite presence is required during the training period; after training, this role may be performed remotely.

Responsibilities: Review and analyze clinical documentation to assign accurate medical codes for diagnoses, procedures, and services. Ensure compliance with federal regulations, payer policies, and coding guidelines to minimize claim denials and audits. Collaborate with healthcare providers to clarify documentation and resolve coding discrepancies. Maintain and update coding knowledge by participating in ongoing education and training programs. Prepare and submit coded data for billing and reimbursement processes, ensuring accuracy and timeliness.

Minimum Qualifications: Current Certified Professional Coder (CPC) credential from the AAPC or equivalent certification. Strong understanding of ICD-10-CM, CPT, and HCPCS coding systems and guidelines. Familiarity with medical terminology, anatomy, and healthcare documentation standards. Experience with electronic health record (EHR) systems and coding software. Ability to maintain confidentiality and comply with HIPAA regulations.

Preferred Qualifications: Experience working in a hospital, physician practice, or healthcare billing environment. Knowledge of payer-specific billing requirements and insurance claim processes. Additional certifications such as Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC).Proficiency in auditing and quality assurance of coded data. Strong analytical and problem-solving skills related to coding and reimbursement.

Skills: The required skills enable the Certified Professional Coder to accurately interpret complex clinical documentation and apply appropriate coding standards, which is essential for correct billing and reimbursement. Proficiency with coding software and electronic health records facilitates efficient data entry and claim submission. Strong communication skills are used daily to collaborate with healthcare providers and resolve documentation issues, ensuring coding accuracy. Analytical skills help identify discrepancies and potential compliance risks, supporting audit readiness and quality assurance. Preferred skills such as knowledge of payer-specific requirements and additional certifications enhance the coder's ability to navigate complex billing environments and improve overall revenue cycle performance. WORK ENVIROMENTThe above statements describe the general nature and level of work performed by people assigned to this classification. They are not an exhaustive list of all responsibilities, duties and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.

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