Licensed Medical Coding Reviewer
Job Summary
Performing clinical and coding medical claim reviews, the full-time Licensed Medical Coding Reviewer will ensure compliance with coding practices through comprehensive analysis of medical claims and records while working remotely.
Key responsibilities
- Analyze provider billing practices using code auditing software and regulatory codes
- Review medical records to ensure billing consistency for appeals and adjustments
- Collaborate with the Medical Director to validate decisions and identify medical policy opportunities
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
- Experience in provider communication and education preferred
- Licensure as LPN, RN, CPC, CCS, RHIT, RHIA, or similar credentials
- 2+ years of related clinical experience
Complete Job Description
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