Medical Records Coder II/III - Correctional Health (Open & Promotional)

San Mateo County Health is seeking an experienced Medical Records Coder II/III to join Correctional Health and support the coding of CalAIM billable services, including clinic visits and ancillary services. This position plays an important role in ensuring accurate reimbursement while supporting continuity of care for justice-involved individuals.

The successful candidate will perform billing functions related to the Department of Health Care Services (DHCS) Justice-Involved CalAIM Initiative. This initiative allows eligible incarcerated individuals to enroll in Medi-Cal prior to their release and enables reimbursement for covered healthcare services provided during the 90 days before reentry, helping support successful transitions back into the community.

This position requires independent proficiency in ICD-10 and CPT coding, coding audits, physician education on coding practices, Evaluation and Management (E/M) coding, and identifying and resolving billing edits.

This assignment primarily focuses on professional fee (profee) coding, with the majority of work involving outpatient clinic visits. Additional assignments may include other professional fee chart types. A strong understanding of ICD-10/CPT coding guidelines, code combinations, and documentation requirements is essential for success.

Initial training will be provided onsite in the Health Information Management Department in San Mateo. Following training, the successful candidate will primarily work in the adult correctional facilities in Redwood City and/or the Youth Services Center in San Mateo. Remote work options may be available based on operational needs.

Key Responsibilities 

Depending on the level at which the candidate is hired, responsibilities may include:

• Independently review clinical documentation and assign accurate ICD-10-CM, CPT, HCPCS Level II, Evaluation and Management (E/M), and modifier information for outpatient professional-fee services while applying official coding guidelines, National Correct Coding Initiative (NCCI) edits, payer requirements, and County coding policies. 
• Review coding work queues, claim edits, denials, and unresolved accounts; identify coding, documentation, workflow, or system issues; and take timely action to resolve billing discrepancies. 
• Collaborate with providers and clinical staff to clarify documentation, provide coding education, and promote accurate, complete clinical documentation. 
• Conduct prospective and retrospective coding audits, identify error trends, document findings, and recommend corrective actions. 
• Monitor coding inventory, aging accounts, audit findings, productivity, accuracy, quality, and turnaround-time expectations. 
• Maintain current knowledge of ICD-10-CM, CPT, HCPCS, E/M guidelines, Medi-Cal requirements, CalAIM policies, and other applicable regulations. 
• Collaborate with Correctional Health, Health Information Management, Patient Financial Services, clinical departments, Epic support teams, and other County partners to improve coding procedures, documentation practices, educational resources, and standardized workflows. 
• Maintain patient confidentiality and comply with all privacy, information security, and correctional facility requirements. 
• Perform related duties as assigned.

Why Join Our Team?

This is an opportunity to help build and support an innovative program that expands access to reimbursable healthcare services for justice-involved individuals as they transition back into the community. In this role, you will collaborate with clinical, operational, and revenue cycle teams to improve documentation quality, coding accuracy, provider education, and billing workflows while helping ensure the long-term sustainability of Correctional Health services.

Success in this role requires adapting to evolving CalAIM, Medi-Cal, and coding requirements; resolving complex documentation and billing issues across multiple clinical disciplines; maintaining high standards of coding quality and productivity; and collaborating across departments within a correctional healthcare environment.

The ideal candidate will bring:

Technical Expertise

• Advanced knowledge of ICD-10-CM, CPT, HCPCS Level II, Evaluation and Management (E/M) coding, National Correct Coding Initiative (NCCI) edits, modifiers, and documentation requirements. 
• Experience performing professional-fee and/or outpatient coding in a healthcare setting. 
• Strong understanding of coding compliance, reimbursement methodologies, payer policies, and ethical coding standards. 
• Experience conducting coding audits, identifying error trends, and implementing corrective actions. 
• Proficiency using Epic or another electronic health record, coding encoder, abstracting, or claim-editing system. 
• Experience using reports, dashboards, or other tools to monitor coding quality, productivity, inventory, and unresolved accounts. 
• Ability to accurately interpret medical, behavioral health, substance use treatment, and care-management documentation. 

Professional Skills

• Ability to work independently with minimal supervision while exercising sound judgment within established guidelines. 
• Strong organizational skills with the ability to prioritize competing responsibilities and consistently meet deadlines. 
• Excellent written and verbal communication skills, with the ability to build effective working relationships across multidisciplinary teams. 
• Strong analytical, critical thinking, and problem-solving skills with exceptional attention to detail. 
• Adaptability and a commitment to continuous learning in an evolving healthcare and regulatory environment. 
• A collaborative, team-oriented approach while thriving in a fast-paced setting. 

Preferred Qualifications

• Experience with Medi-Cal, Medicaid, Medicare, or another government healthcare payer. 
• Experience with the CalAIM Justice-Involved Reentry Initiative or another complex public healthcare reimbursement program. 
• Experience coding services in correctional health, community health, behavioral health, substance use treatment, or another integrated healthcare setting. 
• Experience using Epic coding, charge review, claim edit, or revenue cycle work queues. 

IMPORTANT: Candidates for positions in Correctional Health must successfully complete an extensive security clearance conducted by the San Mateo County Sheriff's Office and undergo a thorough background investigation before a final offer of employment can be made.

NOTE: The eligible list generated from this recruitment may be used to fill future extra-help, term, unclassified, and regular classified vacancies.

Duties may include, but are not limited to, the following:

• Assign or verify correct International Classification of Diseases Clinical Modification System and Current Procedural Terminology (ICD10/CPT) codes to outpatient or inpatient medical records.
• Utilize technical coding principles and APC reimbursement expertise to assign appropriate ICD-10-CM diagnoses and ICD-10-CM/CPT procedures.
• Review narrative records of patient treatments and surgical procedures to determine what information is appropriate for coding purposes and prepare case abstracts.
• Enter coded medical records data on computer terminal; select diagnosis and operations codes from computer designated abstracting system.
• Assist in implementing solutions to reduce back-end billing errors.
• Track weekly and follow up on all accounts that cannot be coded.
• Contact doctors, nurses, laboratory and other auxiliary personnel for information needed to complete, correct or clarify medical records and to resolve discrepancies.
• Perform related duties as assigned.

Security Clearance: This position requires that the applicant obtain and maintain a security clearance as a condition of employment.

Note:
The level and scope of the knowledge and skills listed below are related to job duties as defined under Distinguishing Characteristics.

License/Certification:

All Levels
Possession of at least one (1) of the following certifications:

• Certified Coding Specialist (CCS) issued by the American Health Information Management Association (AHIMA). 
• Registered Health Information Technician (RHIT) issued by the American Health Information Management Association (AHIMA).
• Registered Health Information Administrator (RHIA) issued by the American Health Information Management Association (AHIMA).
• Certified Professional Coder-Hospital (CPC-H) issued by the American Academy of Professional Coders (AAPC).
• Certified Professional Coder (CPC) issued by the American Academy of Professional Coders (AAPC).

Knowledge of:

• ICD10 and CPT classification coding systems.
• Fundamentals of anatomy, physiology, and the study of diseases.
• Extensive medical terminology, and hospital accreditation and regulatory standards.
• ICD10 coding guidelines and Ethical Coding standards.
• NCCI edits and hospital modifiers (for the journey level Coders).
• Standard clerical office procedures and equipment including Windows-based software use.

If working at the Medical Coder III level, must also have knowledge of:

• Impact of illness severity on CC/MCC assignments.
• MS-DRG assignment and complex comorbidities.
• Governmental regulations pertaining to billing and coding.

Skill/Ability to:

• Competently select ICD10 to code diagnoses, treatments and procedures for outpatient or inpatient services either by use of coding books or encoder products.
• Competently code procedure using CPT logic.
• Abide by the standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines.
• Maintain Continuing Education for certifications
• Abstract pertinent information from medical records.
• Follow oral and written instructions.
• Operate computer and appropriate coding software and abstract package.
• Effectively communicate technical information to medical and administrative personnel.
• Maintain effective working relationships with others.

If working at the Medical Coder III level, must also have the skill and ability to:

• Assign appropriate evaluation/management level for professional services.
• Analyze and resolve billing edits.

Education and Experience:  
Any combination of education and experience that would likely provide the required knowledge, skills and abilities is qualifying. A typical way to qualify is:

• II level: Three years of experience in coding hospital related services.
• III level: Three years of coding inpatient records.

Open & Promotional. Anyone may apply. Current County of San Mateo and County of San Mateo Superior Court of California employees with at least six months (1040 hours) of continuous service in a classified regular, probationary, extra-help/limited term positions prior to the final filing date will receive five points added to their final passing score on this examination.

The examination process will consist of an application screening (weight: pass/fail) based on the candidates' application and responses to the supplemental questions. Candidates who pass the application screening will be invited to a panel interview (weight: 100%). Depending on the number of applicants, an application appraisal of education and experience may be used in place of other examinations or further evaluation of work experience may be conducted to group applicants by level of qualification. All applicants who meet the minimum qualifications are not guaranteed advancement through any subsequent phase of the examination. All examinations will be given in the County of San Mateo, California and applicants must participate at their own expense.
  
IMPORTANT: Applications for this position will only be accepted online. If you are currently on the County's website, you may click the "Apply" button. If you are not on the County's website, please go to https://jobs.smcgov.org/ to apply. Online applications must be received by the Human Resources Department before midnight on the final filing date.
 

Tentative Recruitment Timeline
Final Filing Date: Thursday, August 13, 2026, at 11:59 PM PST
Application Screening: Week of August 17, 2026
Panel Interviews: Week of August 31, 2026

The County of San Mateo is an equal opportunity employer.