Medical Coder

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

📋 Description

• Independently examine, assess, and address assigned front-end scrubs, claim holds, and denied claims.

• Process an average of 10 front-end holds/denials each hour.

• Review coding and resubmit corrected claims to insurance providers.

• Generate appeal letters/forms accompanied by medical documentation.

• Maintain a minimum coding accuracy rate of 92%.

• Assign ICD-10-CM and CPT codes with the appropriate modifiers for professional-fee services.

• Evaluate medical records and documentation to identify correct codes for services and diagnoses.

• Ensure diagnosis codes adhere to local and national medical necessity guidelines.

• Utilize internal coding resources, payer guidelines, and reference materials for precise and compliant coding.

• Adhere to HIPAA regulations while ensuring privacy and confidentiality.

• Stay updated on laws, regulations, payer policies, and industry guidance.

• Engage in departmental meetings, one-on-one sessions, and mentorship with the assigned Coding Team Lead.

• Report client trends and coding-related inquiries to the Coding Manager.

• Fulfill and maintain CEU requirements.

• Perform additional assigned responsibilities.

⛳️ Requirements

• Must possess a current AAPC or AHIMA Coding Certification for at least 3 years.

• A minimum of 3+ years of professional coding experience is required.

• Strong understanding of CPT, ICD-10-CM, medical terminology, anatomy and physiology, as well as state and federal Medicare reimbursement guidelines.

• Previous experience in reviewing front-end coding errors prior to submission to insurance.

• Prior experience in reviewing and amending coding from insurance denials.

• Experience in submitting corrected claims and appeals.

• Familiarity with insurance guidelines and Explanation of Benefits (EOBs).

• Proficient in proper English grammar, usage, and professional documentation standards.

• Ability to research and analyze data, draw logical conclusions, and resolve coding or documentation challenges.

• Capability to read, interpret, and apply policies, procedures, laws, and regulations.

• Skill in accurately reading and interpreting medical documentation, clinical terminology, and recorded procedures.

• Proven ability to exercise independent judgment in coding and resolving claims.

• Excellent written and verbal communication skills, including the ability to prepare reports, clarify documentation requirements, and foster collaborative relationships with physicians and staff.

• Strong commitment to maintaining confidentiality and protecting health information.

• Previous experience in a medical billing environment with strict adherence to HIPAA compliance.

• Proficiency in Microsoft Office Suite (Word, Excel, Outlook, Teams).

• Employment eligibility verification through E-Verify for newly hired employees based in the United States.

🏝️ Benefits

• 20 days of fixed paid time off annually, in addition to company holidays.

• Generous parental leave policy.

• Monetary incentives and company-wide recognition for contributions and dedication.

• Comprehensive medical, dental, and vision insurance coverage.

• 100% company-covered short- and long-term disability insurance.

• 100% company-paid basic life insurance.

• Access to discounted legal aid services.

• Pet insurance options available.