Coding Specialist

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

📋 Description

• Review coded claims against the corresponding clinical documentation to pinpoint unsupported codes, gaps in documentation, and recurring mistakes.

• Directly code claims, allocating part of your time to hands-on coding tasks.

• Identify documentation trends, providing sufficient detail to facilitate compliance feedback for clinicians.

• Address payer audits as they arise, managing documentation requests and audit responses in collaboration with our Head of RCM.

• Assist in the MIPS/QPP eligibility evaluation for our provider portfolio.

• Escalate ambiguous or exceptional cases instead of making assumptions.

• Keep precise records of audit outcomes and coding activities utilizing our tracking tools.

⛳️ Requirements

• Strong, recent hands-on experience in medical or behavioral health coding and auditing.

• Proficient in auditing and rectifying coded claims.

• Excellent written communication skills, capable of articulating documentation issues clearly enough for providers to address them.

• Dependable, self-motivated, and comfortable working autonomously.

• Willing to sign a Business Associate Agreement (BAA) and adhere to HIPAA regulations for managing protected health information (PHI).

• Certification (CPC) is advantageous but not mandatory if the experience is substantial.

• Background in behavioral health/psych coding, particularly in E/M and psychotherapy coding.

• Previous experience in audit and compliance is preferred.

🏝️ Benefits

• Remote work opportunity from anywhere in the U.S.

• Flexible, part-time schedule.

• Direct exposure to behavioral health coding across a diverse multi-state, multi-specialty provider portfolio.