Medical Coder

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra Health is looking for a Medical Coder to join our growing team.

Job Summary:

• The Medical Coder reviews medical record documentation to assess the accuracy, completeness, and clinical support of reported diagnoses and procedures, and their impact on reimbursement and compliance for hospital and/or professional charges. This position retrieves and analyzes information from medical records while ensuring adherence to established methods, official coding guidelines, and organizational procedures.

Responsibilities:

• Assures accuracy and timeliness of all applicable review type cases within contract requirements.
• Review medical record documentation to validate the accuracy and appropriateness of reported primary and secondary diagnoses and procedures using ICD-10-CM/PCS and CPT coding conventions.
• Review diagnosis and procedure sequencing using official coding guidelines to ensure accuracy and compliance.
• Review and validate DRG/APC assignment based on documented diagnoses, procedures, and applicable coding guidelines.
• Abstract and compile data from medical records to support accurate reimbursement, documentation integrity, and compliance for hospital and/or professional charges.
• Review medical record documentation to assess clinical support for reported diagnoses, including those with reimbursement or compliance impact.
• Apply applicable coding guidelines and payer rules when evaluating diagnoses, procedures, and reimbursement methodology.
• Identify and document review findings, including coding discrepancies, documentation gaps, or compliance concerns.
• Serve as backup to other administrative functions as assigned.
• Meet job standards for achieving contract deliverables.
• Assist with other job- and education-related duties as assigned.
• Read, understand, and adhere to all corporate policies, including those related to HIPAA Privacy and Security Rules.

The list of responsibilities is not intended to be all-inclusive and may be expanded to include other duties as business needs require.

Required Qualifications

• High school diploma or GED.
• Certification as a Coding Specialist.
• Minimum 2 years experience as a Medical Coder
• Demonstrated proficiency in ICD-10-CM/PCS and CPT coding systems.
• Knowledge of anatomy and physiology and medical terminology.

• Working knowledge of DRG reimbursement methodology and inpatient coding guidelines.

• Experience reviewing inpatient medical records in an acute care setting.

• Experience with coding software, encoder/grouper tools, and electronic medical records.

• Effective written and verbal communication skills.

• Strong attention to detail and analytical skills.

• Efficient data entry and documentation skills.

• Proficiency in the Microsoft Office Suite (Word, Excel, Outlook).

• Ability to meet deadlines with a sense of urgency in a production-driven environment.

Preferred Qualifications

• Ability to perform independent reviews of inpatient medical records to validate reported diagnoses, procedures, and MS-DRG assignment.

• Conduct clinical validation reviews to assess whether reported diagnoses are clinically supported by documentation.

• Apply CMS and payer medical necessity requirements, including the Two-Midnight Rule, when evaluating inpatient admissions and level of care.

• Identify, document, and communicate audit findings, including coding discrepancies, clinical validation concerns, and admission status risk.

• Apply official coding guidelines, CMS regulations, and payer policies to support review determinations.

• Prepare documentation sufficient to support audit reconsiderations or appeals, when applicable.

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at https://careers.acentra.com/jobs

EEO AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Compensation

The pay range for this position is listed below.

"Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level."