Medical Coder

Please make sure your application is complete, including your education, employment history, and any other applicable sections. Initial screening is based on the minimum requirements as defined in the job posting, such as education, experience, licenses, and certifications.  Your experience should also address the knowledge, skills and abilities needed for the role. Incomplete applications will not be considered.

*This position is located Remote United States*

Position Purpose

Responsible for conducting comprehensive reviews of patient medical records to ensure the accuracy, completeness, and appropriateness of medical coding related to Medicare Part C appeals.

Essential Responsibilities

• Complies with all legal requirements regarding coding procedures and practices.
• Conducts audits and coding reviews to ensure all documentation is accurate and precise.
• Review medical records, claims, and supporting documentation to assess the accuracy of assigned diagnosis and procedure codes (ICD-10-CM, CPT, HCPCS).
• Evaluate coding practices for compliance with CMS guidelines, Medicare Part C regulations, and industry standards.
• Identify discrepancies, errors, or inconsistencies in coding and documentation.
• Determine whether services billed are supported by clinical documentation and meet requirements.

Minimum Qualifications

Education

• High School Diploma or equivalent

Certification/Training

•  Medical Coding Certification (i.e. CPC, CCS, CCS-P, CPMA)
• Completion of a medical coding training program with certification

Experience

• 2 years of medical coding experience
• ICD-10-CM, CPT, and HCPCS codes and procedures
• Familiarity with CMS guidelines and Medicare Part C regulations, preferred
• Reviewing medical records for audit, compliance, or appeals purposes, preferred

• Experience in an Independent Review Entity (IRE) or similar appeals environment, preferred
• Utilization review or quality assurance processes, preferred

• Resided in the United States for a minimum of three (3) years out of the last five (5) years (Per Contract Requirement)

Benefits

C2C offers an excellent benefits package, including:

• Medical, dental, vision, life, accidental death and dismemberment, and short and long-term disability insurance
• Section 125 plan
• 401K
• Competitive salary
• License/credentials reimbursement
• Tuition Reimbursement

EOE Vet/Disability