Certified Medical Coder
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Job Description
Certified Medical Coder assigning compliant CPT, HCPCS, and ICD-10 codes for Boomerang Healthcare’s pain-management services. Supporting workers’ compensation billing, audits, reimbursement, and provider documentation.
Responsibilities:
- Perform accurate, compliant, and timely coding of professional and facility pain management services
- Support interventional pain evaluation and management, rehabilitation services, and ancillary procedures
- Review coding-related holds for Boomerang Health Care facilities to ensure documentation compliance and appropriate reimbursement
- Assign CPT, HCPCS, and ICD-10 codes for services performed at BHC facilities
- Apply appropriate modifiers based on payer and service requirements
- Ensure documentation supports medical necessity, procedural complexity, and level of services
- Apply correct diagnosis sequencing and body-part specificity for workers’ compensation claims
- Support workers’ compensation documentation requirements, including injury dates, causality, and treating physician narratives
- Collaborate with billing teams on claim formats, attachments, and workers’ compensation payer rules
- Ensure compliance with CMS, AMA, NCCI, and OIG guidelines
- Participate in internal and external coding audits and implement corrective actions
- Identify coding trends affecting denials, underpayments, or compliance risk
- Provide feedback and education to providers to improve documentation and coding accuracy
- Assume other responsibilities as appropriate to the position and organizational needs
Requirements:
- High school diploma or equivalent required
- Associate degree preferred
- Active coding certification required: CPC, CCS, or equivalent (AAPC or AHIMA)
- Minimum 3-5 years of medical coding experience in pain management, workers’ compensation billing
- Demonstrated experience with FRP or multidisciplinary rehab models as well as Commercial and Medicare pain management coding
- Ability to work in a fast-paced environment, meet daily deadlines, and collaborate with cross-functional RCM teams
- Experience with multiple EHR/Practice Management systems (IMS, Nextgen, Athena, eClinicalWorks or similar)
- Basic understanding of NCCI edits and payer-specific billing guidelines
- Accuracy and attention to detail, analytical thinking and problem solving and high integrity and compliance focus
- Advanced proficiency in Microsoft Excel (e.g., formulas, pivot tables) and solid skills in other Microsoft Office applications
- Must be available Monday-Friday, 8am-5pm
- Must work 40 hours per week
Benefits:
- Amazing work/life balance
- Generous Medical, Dental, Vision, and Prescription benefits (PPO & HMO)
- 401(K) Plan with Employer Matching
- License & Tuition Reimbursements
- Paid Time Off
- Holiday Pay & Floating Holiday
- Employee Perks and Discount Programs
- Supportive environment to help you grow and succeed
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