California Licensed Medical Coder

Job Summary

Working remotely on a full-time basis, a California Licensed Medical Coder will manage Medicare appeals by reviewing medical records, addressing NCD/LCD denials, and providing uphold justifications while adhering to CMS guidelines.

Key responsibilities

• Review and analyze medical records for Medicare appeals
• Handle NCD/LCD, Duplicate, and MUE denials
• Maintain accurate documentation of reviews and decisions

Required qualifications

• High School Diploma or equivalent
• Coding certificate (CPC, CCS, or equivalent)
• Previous work-from-home experience with a HIPAA-compliant office
• Strong understanding of medical records review and Medicare appeals
• Experience with denied claims review as an auditor/examiner