CPC Certified Medical Coding Reviewer

Job Summary

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

Key responsibilities:

• Provide pre-pay production reports and coordinate with management for performance improvement
• Recommend process changes and build relationships with cross-departmental teams to address internal system gaps
• Mentor audit analysts and identify training opportunities to enhance team capabilities in coding and documentation

Required qualifications:

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