Certified Medical Coder

Job Summary

A company is looking for a Senior Medical Coder to join their medical record review team.

Key Responsibilities

• Conduct ProFee auditing and ensure compliance with medical necessity determinations
• Utilize NCD/LCD/LCA for documentation and findings related to medical records
• Review and analyze behavioral health documentation as part of the coding process

Required Qualifications

• Certified Professional Coder (CPC) or Certified Professional Medical Auditor (CPMA) with a minimum of two years of experience
• Experience in ProFee auditing; extensive HCC experience will not be considered
• Reside in the US with employment eligibility; sponsorship is not available
• Knowledge of CPT/HCPCS codes related to professional fee services
• Behavioral Health experience is mandatory; familiarity with Medicaid policies is a plus