CPC Certified Medical Coding Reviewer

Job Summary

To support medical record audit activities, the full-time salaried CPC Certified Medical Coding Reviewer will review claims, conduct audits, and collaborate with internal departments while working remotely.

Key responsibilities:

• Review medical records and make payment decisions on various claim complexities according to department standards
• Research and analyze moderately complicated claims to ensure compliance with medical coding guidelines
• Prepare claim audit summaries for Medical Director review and identify process improvement opportunities

Required qualifications:

• Associate's degree required, or equivalent relevant work experience
• Three (3) years of medical bill coding experience required
• Certification as a Medical Coder (CPC, RHIT, or RHIA) required at time of hire
• Medicaid/Medicare experience preferred
• Clinical background with understanding of claims payment preferred