CPC Certified Medical Coding Reviewer

Job Summary

Supporting complex medical record audit programs, the full-time CPC Certified Medical Coding Reviewer III will manage pre-pay production reports, recommend process changes, and mentor audit analysts while working remotely.

Key responsibilities:

• Provide production and progress reports for Provider Pre Pay and coordinate with management for performance improvement
• Recommend process changes and build relationships with cross-departmental teams to address internal system gaps
• Oversee and mentor audit analysts, ensuring accurate audit decisions and identifying training opportunities

Required qualifications:

• Associates degree or equivalent relevant work experience
• Five years of medical billing and coding experience, including three years in SIU/FWA coding
• Prior experience with claim pre-payment and medical claim auditing
• Medicaid and Medicare experience required
• Certified Medical Coder (CPC, RHIT, or RHIA) required at time of hire