REMOTE Medical Coding Specialist

Review clinical documentation to accurately assign and sequence CPT, HCPCS Level II, and ICD-10-CM codes for professional and facility charges (clinic visits, office-based services, ASC surgeries, optical services, and durable medical equipment). Apply appropriate modifiers, correct visit levels (E/M), and diagnosis-to-procedure linkages to ensure compliance with NCCI bundling edits and payer rules. Collaborate with ASC surgical staff to verify actual procedures performed and code facility charges accordingly. Assist with the assignment of CPT, HCPCS, and ICD-10 codes for pre-authorization of services. Process, balance, and prepare charges for timely submission to insurance carriers and patient billing. Auditing, Clinical Documentation Improvement & Provider Education Monitor and track incomplete encounters to ensure all clinical documentation is completed timely and prior to code finalization; query physicians regarding outstanding documentation needs. Read, interpret, and audit medical charts in accordance with organizational protocol to identify documentation improvement trends and compliance risks. Develop tailored educational materials and present audit findings, coding updates, and documentation procedures to physicians and clinical staff. Serve as an internal subject-matter resource for coding, documentation integrity, and medical necessity rules. Edits, Denials & Revenue Cycle Support Resolve pre-claim submission edits and work queues assigned to coding to facilitate clean, timely claim processing. Support billing and AR teams with reviewing previously coded charges, resolving coding-related claim denials, and preparing formal appeals. Stay current with insurance regulations, legislative updates, and payer policy changes; communicate relevant updates to management in a timely manner. Attend departmental meetings and participate in ongoing educational activities to keep skills and credentials up to date. Maintain patient confidentiality in strict compliance with HIPAA, state, federal, and company regulations. Proactively identify, report, and participate in resolving any potential or actual patient safety concerns, while supporting overall clinic workflow efficiency. Requirements Education: High school graduate or high school equivalency credential. Experience: Minimum 3 years of Ophthalmology medical coding and billing experience. Credentials: Active coding certification (CPC or CPOC) Coding & Billing Knowledge: Working knowledge of CPT, HCPCS, and ICD coding systems, visit levels (E/M), modifiers, bundling edits, and general medical billing practices. Chart Review & Auditing: Proven ability to read, interpret, and audit complex medical records against clinical documentation standards. Schedule/Shift: Flexible schedule for 25-30 hours a week between M-F 8am-5pm EST **Can sit in any state except AK, CA or HI** #J-18808-Ljbffr