Medical Coding Consultant

You will serve as a key liaison between operational billing staff and the coding technology vendor, helping identify opportunities to improve coding accuracy, accelerate claims processing, reduce claim holds and coding-related denials, and strengthen overall revenue cycle performance. Key Deliverables: Claims hold reduction strategy Root cause analysis report KPI dashboard Monthly performance review Compensation details: 25-33 Hourly Wage PI5dd3ddeb34eb-25448-418087655c143e31-5e48-4549-b638-05792d185386

Make an Impact on Coding Accuracy, AI Innovation & Revenue Cycle Performance We’re looking for an experienced and highly motivated Independent Medical Coding Consultant to help strengthen our clinical coding, billing, and revenue cycle operations. This is an exciting opportunity for a coding subject matter expert who enjoys solving complex problems, improving processes, mentoring teams, and helping shape the future of AI-assisted medical coding. In this role, you’ll work at the intersection of medical coding, revenue cycle operations, technology, and artificial intelligence , partnering with internal billing teams and the XpertDox technology team to improve accuracy, efficiency, and claim performance. The ideal consultant is detail-oriented, collaborative, and energized by the opportunity to turn coding insights into measurable operational improvements. About the Role The Independent Medical Coding Consultant will provide subject matter expertise in clinical coding validation, AI-assisted coding optimization through XpertDox, and billing workflow improvement within Athena . You will serve as a key liaison between operational billing staff and the coding technology vendor, helping identify opportunities to improve coding accuracy, accelerate claims processing, reduce claim holds and coding-related denials, and strengthen overall revenue cycle performance. Key Objectives In this role, you will help us: Validate corrected medical claims and coding recommendations generated through XpertDox. Improve AI-assisted coding accuracy through feedback, testing, and training. Build internal billing team expertise in coding validation and claim correction. Reduce claim holds, missing slips, and coding-related claim denials. Establish standardized coding validation, workflow, and quality assurance processes within Athena. Improve billing efficiency and claim throughput while maintaining regulatory and coding compliance. Key Responsibilities 1. Coding Validation & Quality Assurance You will provide expert review and oversight of coding accuracy by: Reviewing and validating corrected claims prior to submission. Auditing coding recommendations generated by XpertDox AI. Verifying diagnosis, procedure, and modifier selection against provider documentation. Identifying coding discrepancies and documentation deficiencies. Providing corrective recommendations to billing and clinical teams. Conducting random and targeted claim audits to measure coding accuracy and identify trends. Key Deliverables: Coding validation reports Monthly audit findings and trend reports Coding error tracking log Process improvement recommendations 2. XpertDox AI Optimization & Vendor Collaboration Partner with XpertDox implementation and technical teams to continuously improve AI-assisted coding performance. Responsibilities include: Reviewing AI-generated coding output. Providing detailed feedback on coding accuracy and missed coding opportunities. Identifying patterns contributing to coding errors or claim holds. Participating in testing and validation of AI model enhancements. Supporting the development and refinement of coding rules, logic, and validation protocols. Translating real-world coding expertise into actionable recommendations for technology improvements. Key Deliverables: AI performance assessment reports Coding correction and feedback logs User acceptance testing documentation Recommendations for AI training and performance improvements 3. Billing Team Education & Knowledge Development Help build a stronger, more confident billing team through practical education and ongoing coaching. You will: Train billing personnel on coding review and validation procedures. Educate staff on ICD-10, CPT, HCPCS, modifiers, and documentation requirements. Develop job aids, training materials, and coding reference guides. Conduct workflow coaching and ongoing competency development sessions. Provide case-based learning using real-world claims examples. Help establish consistent coding review practices across the team. Key Deliverables: Training curriculum Standard operating procedures (SOPs) Billing reference guides Monthly training sessions Staff competency assessments 4. Athena Workflow Assessment & Optimization Evaluate current revenue cycle workflows and identify opportunities to make billing processes more efficient and effective. You will: Review existing Athena revenue cycle workflows. Analyze the causes of claim holds and work queue backlogs. Assess missing slip workflows and charge capture processes. Develop standardized claim review and escalation procedures. Create work queue management and prioritization processes. Recommend automation opportunities and process redesign initiatives. Develop practical solutions that improve workflow consistency and claim throughput. Key Deliverables: Current-state workflow assessment Future-state workflow design Athena work queue optimization recommendations Workflow maps and SOP documentation 5. Claims Hold Reduction Initiative Take a data-driven approach to identifying and reducing preventable claim holds. You will: Analyze historical claims hold data. Categorize and identify root causes of claim holds. Develop corrective action plans. Establish quality checkpoints before claim submission. Monitor hold rates and improvement metrics. Report trends and recommendations to stakeholders. Key Deliverables: Claims hold reduction strategy Root cause analysis report KPI dashboard Monthly performance review Compensation details: 25-33 Hourly Wage PI5dd3ddeb34eb-25448-418087655c143e31-5e48-4549-b638-05792d185386