Medical Coder Coordinator

*** Please note: The manager would like to see a bigger focus on inpatient coding experience, with CPT codes, modifiers, and retrospective coding reviews. ***

Team prefers to see candidates with 3 -5 years of experience.

Candidates must has IDRE experience and be able to explain the IDR process during the interview

Location: Remote
Duration: 6 months - Term to Perm
Hours: 9a - 5:30pm EST Mon - Fri

Description :
We are seeking a highly motivated and detail oriented professional to join our team and perform retrospective payment reimbursement reviews. The ideal candidate thrives in a fast paced, deadline driven environment and can effectively manage multiple priorities with accuracy and efficiency.
This individual must have a strong understanding of how modifiers impact reimbursement and how CPT codes interact with one another. The candidate should also be proficient in reading and interpreting Explanations of Benefits (EOBs), including recoupments, corrections, and other claim adjustments. Additionally, a broad and in depth knowledge of CPT codes across all provider specialties is essential.

1. Certified Medical Coder- certification from recognized organizations such as the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA), Certified Professional Coder (CPC) or Certified Coding Specialist (CCS).
2. Knowledge of Medical Billing and Coding Systems: Familiarity with coding systems such as ICD-10-CM, CPT, and HCPCS is essential as well as experience with CPT modifiers and how they impact reimbursement.
3. Attention to Detail: Accuracy is critical in the medical coding review to ensure correct billing and compliance with regulations. Attention to detail helps in avoiding errors that could lead to billing disputes or legal issues.
4. Understanding of the No Surprises Act: An understanding of the No Surprises Act and its implications for billing practices is preferred.
5. Excellent writing skills: The coder will be responsible for writing final and binding payment determination letters that will be distributed to our client as well as the disputing parties.

Education Requirement:
• High School Diploma or GED is required. An Associate's degree from an accredited college or university is preferred