About this role
Role Overview
- Assign accurate ICD-10-CM, PCS, CPT, and HCPCS codes from provider documentation and clinical records
- Apply official guidelines, payer policies, NCCI edits, and modifier rules to improve clean-claim rates
- Review charts for specificity, medical necessity, and documentation gaps; escalate to CDI/provider queries as needed
- Support denial prevention and resolution by analyzing claim edits and root causes
- Maintain productivity and accuracy targets and document coding rationale
- Protect PHI and follow HIPAA/security best practices in a fully remote environment
- Collaborate with billing, AR, compliance, and clinical teams to improve revenue cycle performance
- Assist in other duties as assigned
Requirements
- Active credentials such as CPC, CCS, CIC, COC, or CRC (coding certification must be role-aligned)
- 3+ years of experience in medical coding for professional fee and facility
- Speciality coding experience (ER, IP, OBS, Swing) strongly preferred
- Experience with coding audits, second-level reviews, and coder coaching preferred
- Familiarity with denial management, payer policy research, and appeals support preferred
- Strong knowledge of ICD-10-CM, PCS, CPT, HCPCS, modifiers, and E/M guidelines
- Experience with encoder/grouper tools, EHR workflows, and claim edit concepts (e.g., NCCI)
- Experience coding without encoder/grouper tools
- Working knowledge of HIPAA, documentation standards, and audit expectations
- Ability to work independently in a remote, metric-driven environment
Benefits
- Access to a 401(k) Retirement Savings Plan.
- Comprehensive Medical, Dental, and Vision Coverage.
- Paid Time Off.
- Paid Holidays.
- Additional benefits, including Pet Care Coverage, Employee Assistance Program (EAP), and discounted services.