Medical Coding Specialist

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

📋 Description

• The Medical Coder is tasked with the independent review, analysis, and resolution of all assigned front-end claims to guarantee accurate and timely submission.

• This role emphasizes the identification and correction of coding-related discrepancies before claim transmission, utilizing established coding guidelines, payer requirements, and organizational policies.

• The Medical Coder collaborates closely with revenue cycle partners to mitigate claim rejections, enhance clean claim rates, and foster efficient reimbursement processes.

• This position necessitates strong attention to detail, foundational coding expertise, and the capacity to work autonomously in a dynamic environment.

• Handles an average of 10 front-end holds per hour.

• Maintains a minimum coding accuracy rate of 90%.

• Assigns ICD-10-CM and CPT codes with appropriate modifiers for services rendered in the professional fee setting.

• Reviews medical records and relevant documentation to ascertain the correct codes for documented services and diagnoses.

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

• Leverages internal coding resources, payer guidelines, and other reference materials to ensure precise and compliant coding for all assigned services.

• Adheres to all HIPAA regulations while upholding the highest standards of privacy and confidentiality.

• Stays updated on laws, regulations, payer policies, and industry guidance affecting compliant coding practices.

• Independently evaluates and resolves all assigned front-end claim holds.

• Actively engages in department meetings, one-on-one sessions, and mentorship meetings with the designated Coding Team Lead.

• Flags identified client trends to the designated Coding Team Lead.

• Directs all coding-related inquiries to the assigned Coding Team Lead for guidance and clarification.

• Maintains and fulfills all Continuing Education Unit (CEU) requirements.

• Executes other duties or tasks as assigned.

⛳️ Requirements

• Must possess a current AAPC or AHIMA Certification with a minimum of 3 years of experience.

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

• Familiarity with proper English grammar, usage, and professional documentation standards.

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

• Proficient in reading, interpreting, and applying policies, procedures, laws, and regulations.

• Capability to accurately read and interpret medical documentation, clinical terminology, and recorded procedures.

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

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

• Strong commitment to preserving confidentiality and protecting health information.

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

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

• Minimum of 3+ years of professional coding experience.

🏝️ Benefits

• Generous Paid Time Off: Recharge and relax with 20 days of fixed time off per year, in addition to company holidays—because we believe work-life balance fuels performance.

• Best-in-Class Parental Leave: Spend quality time with your growing family. We offer one of the industry’s most generous parental leave policies to support you during life’s most important moments.

• Recognition & Rewards: We celebrate wins—big and small. Get rewarded with monetary incentives and company-wide recognition for your impact and dedication. Your hard work won’t go unnoticed.

• Comprehensive Insurance Coverage: Stay covered with medical, dental, and vision insurance, plus 100% company-paid short- and long-term disability and basic life insurance. Optional perks include discounted legal aid and pet insurance.