Certified Coder

The Certified Professional Coder (CPC) serves as liaison between the medical group and the external coding vendor. This role ensures consistent communication, accurate and compliant coding practices, timely issue resolution, and alignment with organizational policies and payer requirements. The Coding Liaison supports documentation integrity, monitors vendor performance, and acts as a subject matter expert for coding-related inquiries. This role works closely with providers, clinical staff, and revenue cycle teams to review medical records, validate documentation completeness, apply correct CPT®, ICD-10-CM, and HCPCS codes, and educate providers on documentation best practices.

Key Responsibilities

• Serve as the liaison to ensure coding queries issued by the vendor are addressed by providers, resolved appropriately, and returned to the vendor in accordance with established timelines.
• Identify documentation deficiencies and initiate provider queries when clarification is needed
• Apply current CMS, payer, and organizational coding guidelines
• Assist with coding-related denials, audits, and appeals
• Stay current with coding updates, rule changes, and ongoing education requirements

Qualifications
Medical Coder Qualifications/Skills: Active AAPC certification (CPC®) 3+ years of medical coding experience. Strong knowledge of: • CPT®, ICD-10-CM, and HCPCS coding guidelines • E/M coding (including 2021+ E/M guidelines if applicable) • CMS and major payer regulations • Provider education and relationship management Preferred Qualifications Proficiency in electronic health records (EHR) and encoder systems Experience in hospital, multispecialty, or high-volume outpatient environments Familiarity with auditing, compliance programs, and denial resolution Excellent attention to detail and analytical skills Strong written and verbal communication skills Administrative writing skills Reporting skills Proficiency in Microsoft Office Product Suite.