Maryland Licensed Coder Reviewer

Job Summary

To support independent dispute resolutions, the part-time Maryland Licensed Coder Reviewer will conduct clinical documentation reviews, perform compliance audits, and generate detailed reports while working remotely.

Key responsibilities:

• Conducting reviews and determinations for independent dispute resolutions at Federal and State levels
• Performing compliance audits and data abstraction activities according to specified protocols
• Generating well-written deliverables and providing feedback to hospitals regarding audit findings

Required qualifications:

• 2+ years of relevant experience in complex coding, quality assurance, or auditing services involving ICD-10-CM/PCS, CPT/HCPCS
• Bachelor's degree in a related discipline or specialized licensure/certification (e.g., RHIA, RHIT, CCS, CPC)
• Practical knowledge of HIPAA and regulations concerning confidentiality and privacy of health information
• Ability to communicate effectively with clients and other reviewers regarding audit findings
• Senior-level outpatient hospital coding experience with a proven track record in auditing clinical coding