Adjudication, Analysis Skills, Billing, Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Claims Processing, Code Reviews, Communication Skills, Consulting, Current Procedural Terminology (CPT), Detail Oriented, Documentation, Healthcare Common Procedure Coding System (HCPCS), High School Diploma, ICD-10, Medical Coding, Multitasking, Organizational Skills, Patient Care, Regulations, Regulatory Compliance, Regulatory Requirements, Reimbursement, Time Management, Writing Skills
Job Title: Medical Coder Coordinator
Location: Remote (100%)
Duration: 6-Month Contract to Hire
Schedule: Monday – Friday | 9:00 AM – 5:30 PM EST
Pay Rate: $21.42/Hour
Position Overview:
- We are seeking a detail-oriented and highly motivated Medical Coder Coordinator to join our team in a fully remote capacity. This role focuses on retrospective payment reimbursement reviews and requires strong inpatient coding experience, extensive CPT coding knowledge, modifier expertise, and the ability to interpret complex reimbursement documentation.
- The ideal candidate will thrive in a fast-paced, deadline-driven environment while maintaining exceptional accuracy and compliance standards.
Key Responsibilities:
- Perform retrospective payment reimbursement reviews and coding audits.
- Review and interpret Explanations of Benefits (EOBs), including:
- Recoupments
- Corrections
- Claim adjustments
- Apply CPT, ICD-10-CM, and HCPCS coding guidelines accurately.
- Analyze CPT modifiers and evaluate their impact on reimbursement.
- Conduct coding reviews across multiple provider specialties.
- Prepare clear, professional, and compliant final payment determination letters.
- Ensure coding accuracy and compliance with payer and regulatory requirements.
- Support dispute resolution processes related to reimbursement reviews.
- Manage multiple priorities while meeting strict deadlines.
Required Qualifications:
- 3–5 years of medical coding experience preferred.
- Strong inpatient coding experience required.
- Hands-on experience with:
- CPT codes
- CPT modifiers
- Retrospective coding reviews
- Experience with the IDR/IDRE process is required and candidates must be able to explain the process during interviews.
- Strong understanding of reimbursement methodologies and claim adjudication.
- Ability to read and analyze EOBs effectively.
- Excellent written communication and documentation skills.
- High attention to detail and accuracy.
Certifications Required
One of the following certifications is required:
- CPC (Certified Professional Coder) – AAPC
- CCS (Certified Coding Specialist) – AHIMA
- Equivalent coding certification from AAPC or AHIMA
Preferred Qualifications:
- Knowledge of the No Surprises Act and related billing regulations.
- Associate degree from an accredited college or university preferred.
Education Requirements:
- High School Diploma or GED required.
- Associate Degree preferred.
C
Careers Integrated Resources Inc