The Contra Costa Health Department is seeking a Medical Records Coder for the Contra Costa Health Plan (CCHP) Claims Unit in Martinez, CA.
This role is responsible for accurate coding, auditing, validation, and adjudication of medical claims. The position supports claims payment accuracy, system integrity, and compliance with state and federal regulations.
Key responsibilities include:
- Researching coding issues, guidelines, and reimbursement methodologies
- Auditing medical claims for coding accuracy and payment discrepancies
- Identifying potential fraud, waste, and abuse (FWA)
- Reviewing provider contract configurations, reimbursement methodologies, fee schedule updates, and coding changes
- Collaborating with IT and operational teams to resolve coding, reimbursement, and claims processing issues
- Supporting internal and external audits with coding expertise, documentation, and guidance
Requirements & Qualifications
Minimum qualifications
- Valid AHIMA CCS or CCS-P certification
- Or valid AHIMA CCA, AAPC CPC-A, CPC-H-A, CPC-P-A, or AAPC CIC certification
- Or valid AAPC CPC, COC, or CPC-P certification
- Or valid RHIA, RHIT, or CTR certification plus at least 6 months of experience abstracting and coding medical data in a hospital, medical office, outpatient clinic, or managed care organization
- Copy of certification(s) must be attached to the application
Desired qualifications
- Experience with medical claims, reimbursement, and payment methodologies
- Experience identifying fraud, waste, and abuse through coding review, documentation analysis, and claims auditing
- Ability to analyze documentation, resolve coding discrepancies, and apply coding guidelines
- Commitment to ongoing learning and staying current with coding, reimbursement, and healthcare regulatory changes
Core competencies
- Critical thinking
- Attention to detail
- Oral and written communication
- Adaptability
- Professional integrity and ethics
Benefits & Perks
Benefits and perks
- Strong and supportive leadership team
- Advancement opportunities
- Work that directly benefits community services and programs
- Excellent employee benefits and retirement
Location
California, US
Employment Type
Full-time
Experience Level
Entry Level
Salary Range
$72,873 - $88,578
Remote work allowed
No
Posted
1 month ago
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