Certified Medical Coder

Job Summary

Working remotely in a full-time capacity, the Certified Medical Coder will perform automated and complex reviews of Medicare Fee-for-Service claims to assess payment accuracy, ensuring compliance with Medicare policies and guidelines.

Key responsibilities

• Conduct automated and complex reviews of Medicare claims, documenting findings accurately
• Participate in dispute resolution and provide supporting documentation for claims re-examination
• Collaborate with key personnel to ensure consistency and continuous improvement in review activities

Required qualifications

• 5+ years of direct medical coding or billing experience in a healthcare environment
• 3+ years of experience in a productivity-based claims or case management environment
• 3+ years of remote work experience with technology systems, preferably in Medicare Fee-for-Service
• Experience with inpatient coding and DRG validation, including compliance monitoring
• Certification from an accredited association such as AAPC or AHIMA is required