Remote 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 consistency for appeals and adjustments
• Collaborate with the Medical Director to validate decisions and identify policy opportunities

Required Qualifications

• Associate's degree in a related field or equivalent experience
• Coding certification (CPC, CCS, etc.) and 2+ years of experience in medical billing & coding
• Experience in coding/data analysis, accounting/business, or clinical experience as RN/LPN
• Preferred experience in provider communication and education
• Licenses such as LPN, RN, or other relevant certifications are required