Certified Medical Coder

Job Summary

To support a data-driven healthcare initiative, the full-time Certified Medical Coder will perform coding-focused medical reviews of Medicare Part A/B and DMEPOS claims remotely, ensuring compliance with Medicare policies and documenting findings accurately.

Key Responsibilities

• Perform coding-only medical reviews on Medicare claims, applying relevant coding rules
• Research and apply National and Local Coverage Determinations (NCDs/LCDs) to document coding determinations
• Identify potential improper payments and coding errors for referral consideration

Required Qualifications

• 3+ years of experience in medical coding, billing, or coding quality assurance/auditing
• Active coding certification through AAPC or AHIMA (e.g., CPC, CCS, RHIA)
• Ability to research and apply CMS coverage and coding rules
• Associate's degree in a related discipline or equivalent experience
• Working knowledge of HIPAA and CMS system security requirements