What You'll Do
Review and process medical claims across multiple service lines, including office visits, hospital procedures, endoscopy, anesthesia, imaging, and pathology. Analyze clinical documentation from EMRs and hospital systems to assign accurate codes and ensure alignment with billing requirements. Apply current coding standards and evaluate physician documentation to verify that billed levels are supported by recorded care details.
Prepare and manage claims for submission by linking authorizations, coding lab results, and applying correct modifiers when necessary. Communicate with physicians and office managers to resolve documentation gaps or clarify operative reports. Support auditing workflows by placing claims on hold when needed and resubmitting after resolution. Provide actionable feedback to improve coding accuracy and compliance across departments.
Requirements
High School Diploma or GED required. Certification as a CPC or equivalent credential through AAPC or AHIMA is mandatory. Demonstrated expertise in medical coding, billing compliance, patient registration, and financial reporting is essential. Proficiency with EMR systems, Microsoft Excel, and Office applications is expected. Strong written and verbal communication skills, along with the ability to analyze processes and identify improvements, are critical. Must uphold strict confidentiality regarding patient health information and internal data. Experience in designing or improving workflows with cross-departmental teams is valued. Prior remote collaboration experience is a plus.
Benefits
Comprehensive benefits package includes health, dental, and vision insurance, along with life and disability coverage. Additional offerings include 401(k) with profit-sharing, HSA and FSA options, paid time off, paid holidays, and pet insurance. The organization supports employee well-being through accessible healthcare plans, including Cigna, and promotes long-term financial security with short- and long-term disability protections.
