Florida Licensed Medical Coding Reviewer

Job Summary

A company is looking for a Medical Coding Reviewer I to perform clinical and coding medical claim reviews.

Key Responsibilities

• Analyze provider billing practices using code auditing software and regulatory guidelines
• Review medical records to ensure billing accuracy for appeals and adjustments
• Identify potential billing errors, abuse, and opportunities for prepayment reviews

Required Qualifications

• Associate's degree in a related field or equivalent experience
• Coding certification and 2+ years of experience in medical billing & coding or related clinical experience
• Active RN or LPN license in the candidate's state
• Experience in provider communication and education preferred
• Relevant coding certifications such as CPC, CCS, RHIT, or similar