Florida Licensed Medical Coding Reviewer

Job Summary

A company is looking for a Medical Coding Reviewer I.

Key Responsibilities

• Perform clinical and coding medical claim reviews for compliance with coding practices
• Analyze provider billing practices and review medical records for consistency with billing
• Identify potential billing errors, abuse, and fraud, and assist with health plan coding questions

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 fields
• 2+ years of related clinical experience as an RN or LPN
• Licensure as LPN, RN, or relevant coding certifications (e.g., CPC, CCS)
• Experience in provider communication and education preferred