Medical Coder

Job Summary

The Medical Coder is responsible for accurately reviewing, coding, and validating medical documentation for primary care services in accordance with applicable coding guidelines, payer requirements, and regulatory standards. This role supports accurate billing, compliance, quality reporting, and risk adjustment by ensuring clinical documentation is complete, accurate, and properly coded for both commercial and Medicare populations.

Required Experience

Minimum of 2–3 years of medical coding experience in a primary care or outpatient setting
Experience with Medicare, Medicare Advantage, and commercial payers required
Risk adjustment and HEDIS coding experience preferred

Licenses / Certifications

One or more of the following required:

• CPC (AAPC)
• CCS or CCS-P (AHIMA)
  Additional risk adjustment certification preferred (CRC, COC, or equivalent)

Knowledge, Skills & Abilities (KSAs)

• Advanced knowledge of ICD-10-CM, CPT, and HCPCS coding guidelines
• Strong understanding of CMS, Medicare Advantage, and commercial payer requirements
• Knowledge of HEDIS measures and risk adjustment principles
• Ability to analyze clinical documentation and identify coding gaps
• Strong attention to detail and accuracy
• Ability to communicate effectively with providers regarding documentation clarification
• Proficiency with EHR and coding software

Ability to manage productivity expectations while maintaining quality standards

ALL APPLICANTS ARE SUBJECT TO BACKGROUND SCREENING THROUGH THE AGENCY FOR HEALTH CARE ADMINISTRATION (AHCA)

Please see the link below to the new Care Provider Background Screening Clearinghouse Education and Awareness website. This site was implemented under the directive of House Bill 531 (2025).

https://info.flclearinghouse.com