593 Certified Professional Biller jobs in the United States

• Provide a variety of complex and technical assignments relating to medical coding.
• Analyze, code, and abstract information for the purpose of assigning and entering appropriate and consistent diagnoses and procedure codes for reimbursement.
• Resolve discrepancies on coding related issues.
• Review and correct rejected claims from various third party carriers.
• CPMP account notification/accounts receivable report (IDX), ICD-10 coding.
• Account maintenance - IDX pending report.
• Track all IDX record requests.
• Maintain PK files for validity, coding/billing errors.
• Monitor TES Open Encounter file.
• CLIA renewals for all sites.
• Perform all other duties as assigned by management.

• Certified Professional Coder (CPC) Certification.
• Associate's Degree.
• In lieu of an Associate's degree, 5 years of experience is required.
• Working knowledge of coding requirements
• Must have excellent expressive and written communication skills.
• Must be highly organized.
• Must be proficient in Microsoft Office Word and Excel.

Certified Coder

• Oakland, CA

• Information Systems

• Health Information Servcies

• Full Time - Day

• 28.19 - 46.95

• Req #:

• FTE:1

• Posted:August 6, 2025

Summary

SUMMARY: Reads and interprets medical record documentation to assign diagnosis codes, assigns CPT codes, and applies knowledge of payer reimbursement guidelines to ensure proper reimbursement. Performs related duties as required.

DUTIES & ESSENTIAL JOB FUNCTIONS: NOTE:The following are the duties performed by employees in this classification, however, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.

1. Adheres to the ICD-9-CM (International Classification of Diseases, 10th revision, Clinical Modification) coding conventions, official coding guidelines approved by the cooperating parties, the CPT (Current Procedural Terminology) rules established by the American Medical Association, and any other official coding rules and guidelines established for use with mandated standard code sets.

2. Selection and sequencing of diagnoses and procedures must meet the definitions of required data sets. Utilizes up-to-date versions of CPT and ICD-10-CM resources and remains current on changes in coding and billing standards.

3. Strives for the optimal payment to which the facility is legally entitled, remembering that it is unethical and illegal to maximize payment by means that contradict regulatory guidelines.

4. Consults physicians for clarification and additional documentation prior to code assignment when there is conflicting or ambiguous data in the health record.

5. Diagnosis coding must be accurate and carried to highest level of specificity; assigns and reports codes that are clearly and consistently supported by documentation in the health record.

6. Follow up status of charges held for clearance; work error reports.

7. Responsible for properly performing month end tasks within the established time-frame including running month end reports for each center assigned and tracking of cases that are not yet billed for the month.

8. Provides feedback and education to physicians regarding billing and documentation.

9. Works with the Billing & Collection team to resolve coding issues.

10. Performs professional fee and documentation audits for a wide variety of specialties.

11. Manage work files to resolve coding edits by researching and using the most up-to-date tools available in order to make the appropriate and compliant corrections for reimbursement.

MINIMUM QUALIFICATIONS:

Education:High School Diploma or equivalent required, Associate's degree preferred.

Minimum Experience:Five years relevant coding experience.

Minimum Experience:Experience coding and auditing professional fee surgical procedures and office visits. Required

Licenses/Certifications:Certified Coding Specialist (CCS-P) or Certified Professional Coder (CPC) certification required from AHIMA or AAPC.

Alameda Health System is an equal opportunity employer and does not discriminate against any employee or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental or physical disability, genetic information, sexual orientation, veteran status, or military background.

If you believe healthcare is a right, that everyone deserves high quality care so they can enjoy their highest level of health and wellbeing, and you value each person's individual story – consider joining us at Neighborhood!

As a coder, you’ll play an important role in the success of the organization by using your attention to detail, coding knowledge, communication and collaboration skills.

About the Role:

You’ll use your teamwork skills and training as you review patient medical records, including physician notes, lab results, and procedure details and translate that information into standardized medical codes used for billing insurance companies and maintaining accurate medical records. Responsibilities include:

• Assigns appropriate medical codes using coding guidelines and reference manuals for diagnoses and procedures
• Verifies accuracy of coded data by checking for consistency and compliance with coding regulations and insurance standards
• Communicates with healthcare providers or other professionals to clarify unclear or missing information in medical records
• Prepares and submits accurate coded claims to insurance companies for reimbursement
• Stays updated on current coding guidelines, regulations, and changes in the medical field through continuous training to maintain compliance
• Analyzes coding trends and identifies potential issues for quality improvement
• Thoroughly understands medical terms, anatomy, and disease processes
• Maintains expertise with the main coding systems, including ICD, CPT and HCPCS
• Works with electronic health record (EHR) systems, coding software, and other relevant computer programs
• Researches and analyzes data needs for reimbursement
• Maintains knowledge of insurance policies, coverage, eligibility, and ability to differentiate between insurance plans
• Develops insight into how insurance companies work and the billing process, ensuring codes align with reimbursement requirements
• Reviews and reconciles claim denials relating to coding
• Ensures the security and confidentiality of patient information as mandated by HIPAA
• Reconciles any closed encounters not billed that are tracked by supervisor weekly
• Maintains production and keeps lag days at the specified timeframe
• Assists and provides training to new hired staff as needed
• Utilizes, maintains, and updates daily coder production log
• Utilizes, maintains and updates Google calendar to organize meetings, work schedule, as well as any work duties and tasks for timely completion
• Maintains and completes CEUs for Coding Certification
• Maintains a 90% or higher on bi-monthly coding audits performed by internal auditor

• High School diploma or equivalent
• Certified Professional Coder
• Able to read, write and speak the English language. A second language of Spanish preferred
• One year prior Medical Coding experience preferred
• One year Medical Billing experience is a plus
• Kindness; you treat each person with respect and compassion, valuing each person’s story
• Resiliency; you see opportunities to innovate and find solutions when challenges arise
• Teamwork; you are open to others’ unique perspectives, and will collaborate to meet shared goals

• Provide a variety of complex and technical assignments relating to medical coding.
• Analyze, code, and abstract information for the purpose of assigning and entering appropriate and consistent diagnoses and procedure codes for reimbursement.
• Resolve discrepancies on coding related issues.
• Review and correct rejected claims from various third party carriers.
• CPMP account notification/accounts receivable report (IDX), ICD-10 coding.
• Account maintenance - IDX pending report.
• Track all IDX record requests.
• Maintain PK files for validity, coding/billing errors.
• Monitor TES Open Encounter file.
• CLIA renewals for all sites.
• Perform all other duties as assigned by management.

• Certified Professional Coder (CPC) Certification.
• Associate's Degree.
• In lieu of an Associate's degree, 5 years of experience is required.
• Working knowledge of coding requirements
• Must have excellent expressive and written communication skills.
• Must be highly organized.
• Must be proficient in Microsoft Office Word and Excel.

Our Central Billing Office is growing! We are looking for a Certified Coder to join our team! Position is a full time , hybrid position, Monday - Friday. Our certified coders provide coding support to multiple departments as well as practitioners and staff.

Responsibilities:

• Timely input of charges in accordance with department needs.
• Maintain strict established charge batch turnaround times set by the department.
• Utilize web-based tools, coding books and other available resources to facilitate accurate charge entry.
• Assist in reducing denials by maintaining required accuracy levels and following outline protocols.
• Process any discrepancy reconciliation and closing of charge batches across all systems.
• Respond to inquiries from provider offices and various internal departments in a timely and professional manner.
• Responsible for Claim Edit Reports and Unassigned Money Reports.
• Comply with and enforce all policies and procedures related to the position, the department and the company.
• Achieve goals set forth by supervisor regarding error-free work, transactions, processes and compliance requirements.

Job Description

Certified Coder - Billing

Onsite - Royal Oak, MI

About Sciometrix

Sciometrix is a leading digital Health company looking for RN Case Manager Spanish. We are a leader in Telehealth -healthcare Virtual care Management. Our mission to engage patients to Deliver better outcomes. Sciometrix is known among customers, peers, and patients for clinical excellence, patient experiences, and provider satisfaction. Since the inception of our patient count, technological solutions have been evolving.

We empower healthcare providers with advanced technology and human expertise, revolutionizing a patient's experience. Our propriety software and related technologies ensure HIPAA compliancy with cloud access. We have established HIPAA-compliant Clinicus, an artificial intelligence (AI) bot that monitors patients 24/7 and ensures fast response in their care management program. Clinicas watches each patient's vitals and alerts our licensed team when a patient's program progress or vitals are varying. Our team will then quickly contact the patient to discuss the change. If needed, we will schedule a physician's appointment .

What's in it for you?

• Purpose-Driven Work

Play a key role in supporting accurate and compliant billing for telehealth services, directly contributing to better healthcare outcomes.

• Growth Opportunities

Advance your career in a growing company that values upskilling, cross-functional collaboration, and continuous learning.

• Team-Centered Culture

Be part of a supportive and collaborative team that values transparency, respect, and professional development.

• Access to Leadership

Work closely with leadership and decision-makers in an environment where your input is valued and your impact is visible.

• Stability and Structure

Enjoy a consistent, full-time schedule with the benefit of working onsite at our& Sciometrix location , where structure and teamwork drive results.

• Exposure to Innovative Healthcare Models

Gain hands-on experience with evolving billing models like telehealth, CCM, and RPM, staying ahead of industry trends.

• Benefits: & Paid time off, Paid Holidays, 401k with company-paid contributions, Medical, Vision, and Dental Insurance, Royal Oak, MI downtown Paid Parking.

About the Role

We are seeking a detail-oriented and credentialed Certified Coder to join our Pre-Billing RCM team. This role is critical in ensuring the accuracy and compliance of medical coding for telehealth services prior to claim submission. The ideal candidate will have hands-on experience with coding, billing guidelines, payer-specific requirements, and telehealth regulations.

Key Responsibilities

• Review clinical documentation and patient encounters for completeness and accuracy before claims submission.
• Assign appropriate ICD-10, CPT, HCPCS, and modifier codes in compliance with telehealth and payer guidelines.
• Validate coding to ensure medical necessity, compliance, and payer-specific rules.
• Work closely with physicians, nurse practitioners, and clinical teams to clarify documentation when needed.
• Flag discrepancies or missing information to reduce claim denials and rejections.
• Assist the Pre-Billing team in identifying coding trends and recommending process improvements.
• Ensure compliance with HIPAA, CMS, and telehealth coding standards.
• Collaborate with billing and AR teams to support clean claims and improve first-pass acceptance rate (FPAR).
• Stay updated with regulatory changes, payer policies, and industry best practices in telehealth coding and billing.

Required Qualifications

• Certification: CPC, COC, CCS, or equivalent coding certification (AAPC/AHIMA recognized).
• Experience: 2–4 years in medical coding with at least 1 year in telehealth or outpatient services preferred.
• Strong knowledge of ICD-10-CM, CPT, HCPCS Level II coding.
• Familiarity with payer-specific billing requirements (Medicare, Medicaid, and Commercial, CCM , RPM).
• Working knowledge of EMR/EHR systems and billing software.
• Excellent communication and documentation skills.
• High attention to detail and ability to work in a deadline-driven RCM environment.

Preferred Skills

• Experience in telehealth-specific coding, professional CPT coding and modifiers.
• Knowledge of pre-billing audit processes and denial management trends.
• Strong analytical and problem-solving skills.
• Ability to work independently and as part of a collaborative team.

Equal Opportunity:& Sciometrix is committed to being an Equal Opportunity Employer, providing equal employment opportunities to all individuals .Sciometrix is committed to being an Equal Opportunity Employer, providing equal employment opportunities to all individualsC