Medical Coder

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

📋 Description

• Conduct independent reviews, analyses, and resolutions of assigned front-end scrubs, claim holds, and denied claims.

• Achieve an average of 10 front-end holds/denials per hour.

• Examine coding and resubmit corrected claims to insurance providers.

• Draft appeal letters/forms accompanied by medical documentation.

• Maintain a coding accuracy rate of no less than 92%.

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

• Review medical records and documentation to identify appropriate codes for services and diagnoses.

• Ensure diagnosis codes comply with local and national medical necessity standards.

• Utilize internal coding resources, payer guidelines, and reference materials to ensure accurate and compliant coding practices.

• Adhere to HIPAA regulations, safeguarding privacy and confidentiality.

• Stay informed about current laws, regulations, payer policies, and industry guidance.

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

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

• Complete and maintain all Continuing Education Unit (CEU) requirements.

• Perform additional assigned responsibilities as needed.

⛳️ Requirements

• Possess a current AAPC or AHIMA Coding Certification for a minimum of 3 years.

• Have at least 3 years of professional coding experience.

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

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

• Experience in analyzing and correcting coding from insurance denials.

• Prior 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 issues.

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

• Competence in accurately reading and interpreting medical documentation, clinical terminology, and documented procedures.

• Demonstrated ability to exercise independent judgment in coding and claim resolution.

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

• Strong dedication to maintaining confidentiality and protecting sensitive health information.

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

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

🏝️ Benefits

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

• Industry-leading parental leave policy.

• Monetary incentives and recognition across the company.

• Comprehensive medical, dental, and vision insurance coverage.

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

• 100% company-paid basic life insurance.

• Access to discounted legal aid services.

• Pet insurance options available.