Certified Medical Coder (Full-Time)

Reports To: Revenue Cycle Manager

Classification: Full-Time, Hourly, Eligible for Overtime

Work Arrangement: On-Site Only | Remote and Hybrid Work Not Available

Position Summary
The Certified Medical Coder is responsible for the accurate, timely, and compliant coding of medical services provided at Rocky Boy Health Center (RBHC). This position reviews clinical documentation, assigns appropriate diagnosis and procedure codes, and ensures coding accuracy to support billing, reimbursement, regulatory compliance, and revenue cycle operations.

The Certified Medical Coder must possess an active professional coding certification and demonstrated experience working with the Epic Electronic Health Record (EHR) system. The position works collaboratively with healthcare providers, billing personnel, and revenue cycle staff to ensure accurate documentation, appropriate coding, and timely claims processing.

Key Responsibilities

• Review medical records and clinical documentation to assign accurate ICD-10-CM, CPT, and HCPCS codes in accordance with established coding guidelines.
• Perform coding functions directly within the Epic EHR system, ensuring accuracy, completeness, and timely processing.
• Review provider documentation to verify that assigned codes accurately reflect services rendered and support medical necessity.
• Identify incomplete, inconsistent, or insufficient documentation and communicate with providers to obtain clarification.
• Collaborate with billing and revenue cycle personnel to resolve coding discrepancies, claim denials, and reimbursement issues.
• Monitor coding-related work queues within Epic and ensure timely resolution of assigned tasks.
• Conduct coding reviews and audits to identify errors, trends, and opportunities for improvement.
• Maintain compliance with applicable federal, tribal, and organizational regulations, including HIPAA, CMS requirements, and official coding guidelines.
• Stay current with changes to coding classifications, payer requirements, reimbursement methodologies, and industry best practices.
• Assist in educating providers and clinical staff regarding documentation requirements and coding accuracy.
• Support organizational efforts to improve coding quality, revenue integrity, and operational efficiency.
• Provide ongoing training and technical assistance to medical providers regarding accurate encounter coding, clinical documentation, and appropriate use of Epic EHR coding functions.
• Educate providers on proper selection and application of ICD-10-CM, CPT, HCPCS, and
• Evaluation and Management (E/M) codes to ensure accurate representation of services rendered.
• Assist providers in identifying and correcting coding and documentation deficiencies that may affect billing accuracy, reimbursement, or regulatory compliance.
• Provide individualized, hands-on guidance to providers regarding encounter completion, diagnosis selection, procedure coding, and documentation requirements within Epic.
• Perform other related duties as assigned.

Minimum Qualifications

• High school diploma or equivalent required. Associate degree in Health Information Management, Medical Coding, Healthcare Administration, or a related field preferred.
• Current professional medical coding certification required, including Certified Professional Coder (CPC) through AAPC, Certified Coding Specialist (CCS) through AHIMA, or an equivalent recognized coding credential.
• Demonstrated professional experience using the Epic Electronic Health Record (EHR) system required.
• Minimum of two (2) years of professional medical coding experience required.
• Proficiency in ICD-10-CM, CPT, and HCPCS coding systems.
• Working knowledge of medical terminology, anatomy, physiology, and healthcare reimbursement practices.
• Familiarity with Medicare, Medicaid, and other third-party payer coding and billing requirements.
• Knowledge of HIPAA regulations and patient confidentiality requirements.
• Strong attention to detail, analytical skills, and ability to identify and resolve coding discrepancies.
• Ability to work independently, manage competing priorities, and meet established productivity and accuracy standards.
• Effective written and verbal communication skills and ability to collaborate with clinical and administrative personnel.

Preferred Qualifications

• Experience coding in an ambulatory or outpatient healthcare setting.
• Experience with IHS or tribal health program All-Inclusive Rate (AIR) reimbursement and associated encounter coding and billing requirements.
• Experience providing coding education, training, and technical assistance to physicians, advanced practice providers, and other clinical personnel, particularly within Epic EHR.
• Experience with Epic coding workflows, charge review, and coding-related work queues.
• Experience working in a tribal health program, Indian Health Service (IHS), or federally funded healthcare organization.
• Experience with coding audits, denial management, and clinical documentation improvement.

Important: Applicants must possess both an active professional medical coding certification and prior hands-on experience with Epic. Candidates who do not meet both requirements will not be considered.