Certified Medical Coder

This is a fully remote position, open to applicants in United States.

📋 Description

• Evaluate medical records and associated documentation to ensure coding accuracy and adherence to Indiana Health Coverage Programs, CMS, AMA, and other relevant standards and regulations.

• Perform coding and documentation assessments independently and communicate preliminary findings to the Lead Reviewer.

• Detect potential coding inconsistencies, documentation shortcomings, and billing compliance concerns.

• Keep comprehensive workpapers that document the procedures conducted, records assessed, findings noted, and conclusions drawn.

• Aid with audit responses and appeals as necessary.

• Ensure all tasks are in compliance with state, federal, and national coding and reimbursement standards.

• Stay updated on CPT, HCPCS, ICD-10-CM, and Medicaid coding guidelines, policies, and regulatory changes.

• Investigate Indiana Medicaid regulations and maintain internal databases of bulletins, policies, and procedures.

• Quickly adjust to shifting priorities, policies, regulatory changes, and review requirements while ensuring precision and meeting deadlines.

⛳️ Requirements

• A coding certification such as CCS, CPC, or CPMA is mandatory.

• Minimum of 1 year of experience in medical coding, claims review, billing compliance, or a related field in healthcare reimbursement.

• Familiarity with Indiana Medicaid policies, payer guidelines, and documentation requirements is preferred.

• Candidates residing in or near the Indianapolis area are preferred.

• Proficiency in Microsoft Excel, Word, and Outlook is required.

• Strong skills in analytical thinking, critical reasoning, problem-solving, and technical writing are essential.

• Ability to operate both independently and collaboratively in a fast-paced setting.

• Experience with healthcare providers is highly preferred.

• Knowledge of healthcare claims data and issues related to fraud, waste, and abuse is preferred.

🏝️ Benefits

• Remote position

• Occasional travel required within Indiana