Medical Coder
Remote · United States
Job Summary
Medical Coder independently reviews front-end claims to assign ICD-10-CM and CPT codes with appropriate modifiers for services in the professional fee environment, ensuring accurate and timely claim submission. Processes documentation to determine appropriate codes, verifies medical necessity, adheres to HIPAA, and utilizes payer guidelines and internal resources to prevent claim rejections and improve clean claim rates. Collaborates with Revenue Cycle partners, participates in team meetings, escalates coding questions to the Coding Team Lead, maintains CEU requirements, and uses strong attention to detail and independent judgment to support compliant coding practices.
Required Qualifications
- Current AAPC or AHIMA Certification (minimum 3 years)
- Strong working knowledge of CPT, ICD-10-CM, medical terminology, anatomy and physiology
- State and federal Medicare reimbursement guidelines familiarity
- Professional documentation standards and English grammar
- Ability to research and analyze data, draw logical conclusions, and resolve coding or documentation issues
- Ability to read, interpret, and apply policies, procedures, laws, and regulations
- Independent judgment in coding and claim resolution
- Excellent written and verbal communication skills
- Experience in medical billing environment with HIPAA compliance
- Proficiency with Microsoft Office Suite (Word, Excel, Outlook, Teams)
- Minimum 3+ years of professional coding experience
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