Medical Coding Review Specialist Job at MMC Group LP (Remote)

Medical Coding Reimbursement Review Specialist

We are seeking an experienced and detail-oriented Medical Coding Reimbursement R...

Location

United States

Salary:

21.42 USD / Hour

MMC Group LP

Expiration Date

Until further notice

Requirements

Certified Medical Coder certification required through recognized organizations such as AAPC or AHIMA
CPC (Certified Professional Coder) preferred
CCS (Certified Coding Specialist) preferred
Strong inpatient coding experience required
3-5 years of medical coding and reimbursement review experience preferred
Experience with CPT codes, ICD-10-CM, and HCPCS coding systems required
Strong understanding of CPT modifiers and reimbursement impact required
Experience with retrospective coding reviews required
IDRE experience required
Must be able to explain the IDR process during the interview

Job Responsibility

Perform retrospective payment reimbursement reviews with a strong focus on inpatient coding
Analyze CPT codes, modifiers, and claim interactions to ensure accurate reimbursement determinations
Review and interpret Explanations of Benefits (EOBs), including recoupments, corrections, denials, and claim adjustments
Evaluate how CPT modifiers impact reimbursement and payment outcomes
Conduct coding reviews across multiple provider specialties with broad CPT code knowledge
Review medical claims for compliance with coding standards and reimbursement guidelines
Prepare clear, accurate, and final binding payment determination letters for clients and disputing parties
Support Independent Dispute Resolution (IDR) cases and demonstrate knowledge of the full IDR process
Maintain compliance with billing regulations, coding standards, and applicable healthcare laws
Manage multiple priorities effectively while meeting strict deadlines in a high-volume environment

What we offer

Medical, dental, and vision coverage
Life and disability insurance
Additional voluntary benefits

Fulltime

Medical Coding Specialist

The Medical Coding Specialist is responsible for obtaining charge capture data f...

Location

United States , Salina

Salary:

Not provided

Central Care Cancer Center

Expiration Date

Until further notice

Requirements

Previous clinical or coding experience
At least 2 years’ experience of medical billing in a Healthcare setting and CPC, required
CEMC, CPMA, and CHONC certifications preferred
Knowledge of CPT and ICD10 coding
Knowledge of HIPAA and OSHA rules and regulations
Knowledge of insurance fee schedules and contractual obligations
Problem Solving
Maintains confidentiality
Balances team and individual responsibilities
Displays willingness to make decisions

Job Responsibility

Obtaining charge capture data from the electronic medical records (EMR) and keying this information into the patient management system daily for multiple assigned locations
Review medical notes and records to identify proper coding of claims
Assigns and translate codes for different services and diagnosis
Review physicians’ notes and charts for accuracy
Maintain current knowledge of coding and keep current with medical compliance and reimbursement policies impacting claims payments
Responsible for daily entering and organizing of codes from EMR into billing management software
Familiar with ICD10 and CPT/HCPCS universal coding systems
Obtains necessary clarification with clinical managers and nursing staff to ensure appropriate billing and charge capture
Manage and track missing charge capture reports or billing information, ensuring timely entry of information prior to month end
Monthly audit of assigned locations (10% of charts)

Fulltime

Surgery Medical Coding Specialist

We are seeking a detail-oriented Surgery Medical Coder to join our team. This ro...

Location

United States , Indianapolis

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High School Diploma or GED required
1–2 years of related experience required
One of the following certifications is required: Certified Professional Coder (CPC), Certified Coding Specialist – Physician-based (CCS-P), Certified Orthopaedic Surgery Coder (COSC)

Job Responsibility

Review and accurately code surgical procedures, diagnoses, and related services
Ensure coding compliance with payer, regulatory, and organizational guidelines
Analyze medical documentation to assign appropriate CPT, ICD-10, and HCPCS codes
Work closely with providers and staff to clarify documentation as needed
Maintain productivity and accuracy standards in a remote work environment
Support billing and reimbursement processes through precise code assignment
Participate in minimal onsite training sessions and periodic team meetings

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Fulltime

Medical Coding Specialist

The Medical Coding Specialist is responsible for obtaining charge capture data f...

Location

United States , Salina

Salary:

Not provided

Central Care Cancer Center

Expiration Date

Until further notice

Requirements

Previous clinical or coding experience
At least 2 years’ experience of medical billing in a Healthcare setting and CPC, required
CEMC, CPMA, and CHONC certifications preferred
Knowledge of CPT and ICD10 coding
Knowledge of HIPAA and OSHA rules and regulations
Knowledge of insurance fee schedules and contractual obligations
Problem Solving
Maintains confidentiality
Balances team and individual responsibilities
Displays willingness to make decisions

Job Responsibility

Obtain charge capture data from the electronic medical records (EMR) and key this information into the patient management system daily for multiple assigned locations
Review medical notes and records to identify proper coding of claims
Assign and translate codes for different services and diagnosis
Review physicians’ notes and charts for accuracy
Maintain current knowledge of coding and keep current with medical compliance and reimbursement policies impacting claims payments
Responsible for daily entering and organizing of codes from EMR into billing management software
Familiar with ICD10 and CPT/HCPCS universal coding systems
Obtain necessary clarification with clinical managers and nursing staff to ensure appropriate billing and charge capture
Manage and track missing charge capture reports or billing information, ensuring timely entry of information prior to month end
Monthly audit of assigned locations (10% of charts)

Fulltime

Physician Coding Review Specialist

Location

United States

Salary:

26.55 - 39.85 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Coding Associate (CCA) certification issued by the American Health Information Management Association (AHIMA)
Coding Specialist - Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA)
Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA)
Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA)
Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC)
Specialty Coding Professional (SCP) certification issued by the Board of Medical Specialty Coding and Compliance (BMSC)
Specialty Medical Coding Certification issued by the American Academy of Professional Coders (AAPC)
Advanced training beyond High School that includes the completion of an accredited or approved program in Medical Coding Specialist
Typically requires 5 years of experience in expert-level professional coding and at least 3 years of experience in the education of clinicians in physician revenue cycle processes, health information workflows, and medical record auditing experience
Advanced knowledge of ICD, CPT, and HCPCS coding guidelines

Job Responsibility

Review assigned codes, which most accurately describe each documented diagnosis and/ or procedure according to established CPT, HCPCS, and ICD-10-CM coding guidelines along with modifier usage and medical terminology
Monitor all coding accuracy at various levels of detail and maintain coding quality as needed
Track coding issues and review coding inaccuracies to highlight areas of improvement
Report or resolve escalated issues as necessary
Responsible for reviewing Clinician documentation and billed codes for Medical Group physicians and non-physician clinicians
Review of medical records in collaboration with key stakeholders such as Internal Audit, Compliance, and Clinic Operations
Responsible for completing all certified coder quality reviews
Working in collaboration with Coding Production Leads and Supervisors
Follows the prospective and/or retrospective review plan to sample employed Clinician's medical record documentation in comparison to services selected for billing, based on best practice methodologies which will be presented and reviewed with Clinicians to provide feedback on proper coding and documentation practices
Follows the necessary schedules for team assignments of documentation/coding accuracy

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

New

Inpatient Coding Specialist

We are looking for an Inpatient Coding Specialist to support accurate inpatient ...

Location

United States , Sacramento

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Hands-on experience coding inpatient medical records in a healthcare, hospital, or revenue cycle environment
Working knowledge of inpatient diagnosis and procedure coding standards, reimbursement groupers, and official coding guidance
Ability to interpret complex clinical documentation and abstract required information with a high level of accuracy
Familiarity with regulatory and payer requirements related to coding, billing, compliance, and data reporting
Proficiency with electronic health records and coding support tools, including systems such as Epic and 3M software
Strong communication skills with the ability to collaborate with providers, documentation specialists, and revenue cycle teams
Effective time management and organizational skills to balance productivity goals, queue management, and quality expectations
Detail-oriented approach with the ability to perform audits, verification activities, and independent problem-solving

Job Responsibility

Examine inpatient charts and translate clinical documentation into accurate diagnosis and procedure codes using applicable classification systems and grouping methodologies
Determine the appropriate reimbursement grouping for each account while confirming discharge status, admission source details, and present-on-admission indicators are recorded correctly
Abstract required clinical and demographic data elements according to facility guidelines and regulatory reporting expectations
Review physician and care team documentation for completeness, identify missing or conflicting information, and pursue clarification when needed to support code assignment
Manage discharged-not-billed work queues to help move accounts through the revenue cycle within established turnaround expectations
Partner with clinical documentation improvement staff and providers to strengthen record completeness and support accurate severity and reimbursement outcomes
Apply coding, billing, and data collection rules consistently to maintain compliance with state, federal, and payer requirements
Use coding and validation tools such as Epic, 3M applications, encoders, audit platforms, and standard office software to verify information and complete assigned work
Maintain productivity and quality benchmarks while working independently, organizing priorities effectively, and resolving issues that affect coding accuracy or timeliness

What we offer

medical insurance
vision insurance
dental insurance
life insurance
disability insurance
401(k) plan

New

Inpatient Coding Specialist

We are looking for an Inpatient Coding Specialist to support accurate inpatient ...

Location

United States , Los Angeles

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Hands-on experience coding inpatient medical records in a healthcare, hospital, or revenue cycle environment
Working knowledge of inpatient diagnosis and procedure coding standards, reimbursement groupers, and official coding guidance
Ability to interpret complex clinical documentation and abstract required information with a high level of accuracy
Familiarity with regulatory and payer requirements related to coding, billing, compliance, and data reporting
Proficiency with electronic health records and coding support tools, including systems such as Epic and 3M software
Strong communication skills with the ability to collaborate with providers, documentation specialists, and revenue cycle teams
Effective time management and organizational skills to balance productivity goals, queue management, and quality expectations
Detail-oriented approach with the ability to perform audits, verification activities, and independent problem-solving

Job Responsibility

Examine inpatient charts and translate clinical documentation into accurate diagnosis and procedure codes using applicable classification systems and grouping methodologies
Determine the appropriate reimbursement grouping for each account while confirming discharge status, admission source details, and present-on-admission indicators are recorded correctly
Abstract required clinical and demographic data elements according to facility guidelines and regulatory reporting expectations
Review physician and care team documentation for completeness, identify missing or conflicting information, and pursue clarification when needed to support code assignment
Manage discharged-not-billed work queues to help move accounts through the revenue cycle within established turnaround expectations
Partner with clinical documentation improvement staff and providers to strengthen record completeness and support accurate severity and reimbursement outcomes
Apply coding, billing, and data collection rules consistently to maintain compliance with state, federal, and payer requirements
Use coding and validation tools such as Epic, 3M applications, encoders, audit platforms, and standard office software to verify information and complete assigned work
Maintain productivity and quality benchmarks while working independently, organizing priorities effectively, and resolving issues that affect coding accuracy or timeliness

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Physician Coding Specialist II

Under the direction of the Revenue Cycle Supervisor – Coding the Physician Codin...

Location

United States , Shaker Heights

Salary:

20.11 - 31.44 USD / Hour

University Hospitals

Expiration Date

Until further notice

Requirements

High School Equivalent / GED
2+ years Of medical billing experience
Billing experience in a multi-specialty group is a plus
Excellent interpersonal skills
Ability to recognize, evaluates, and solves problems
Strong verbal and written communication skills
Extensive knowledge of the claims development process
Basic knowledge of ICD-9 and CPT coding
Ability to handle a variety of tasks with speed, attention to detail, and accuracy
Computer literate

Job Responsibility

Analyzes outstanding insurance accounts
Initiates follow-up on identified accounts
Communicates with payors and internal departments
Researches and responds to telephone inquiries
Reviews and corrects coding edits and denials
May code ICD-10 from written documentation
May abstract CPT/HCPCS codes
May perform computer assisted coding functions
Maintains patient/physician confidentiality
Provides information and feedback to personnel

What we offer

Healthcare
Dental
Vision
Retirement plan options
Additional offerings

Fulltime

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Medical Coding Review Specialist

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