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

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.

St. Joseph's Health is recognized for the expertise and compassion of its highly skilled and responsive staff. The combined efforts of the organization's outstanding physicians, superb nurses, and dedicated clinical and professional staff have made us one of the most highly respected healthcare organizations in the state, the largest employer in Passaic County, and one of the nation's "100 Best Places to Work in Health Care".