Registered Nurse Medical Coder

Job Summary

To support a temporary project, the full-time Remote Medical Reviewer, Registered Nurse Coder will perform automated and complex reviews of Medicare Fee-for-Service claims, ensuring compliance with Medicare policies and documenting findings accurately.

Key responsibilities

• Conduct automated and complex reviews of Medicare claims to assess payment accuracy
• Participate in dispute resolution and provide documentation for re-examined claims
• Collaborate with team members to ensure process improvement and compliance with CMS standards

Required qualifications

• 5+ years of direct medical coding or billing experience in a healthcare environment
• 3+ years of experience in a productivity-based claims or case management setting
• 3+ years of remote work experience with various technology systems
• Active Medical Coding Certification (CPC, CCS, or equivalent) required
• Active Registered Nurse license in good standing in the United States