Position Title: Medical Coder

Work Location: Remote – CST

Assignment Duration: 6 months

Work Arrangement: Remote

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Position Summary

Analyze provider billing practices by utilizing code auditing software, provider documentation, administrative policies, regulatory codes, legislative directives, precedent, AMA and CMS code edit criterion.

Review medical records to ensure billing is consistent with medical record for appeals, adjustments and miscellaneous/unlisted code review.

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Key Responsibilities

• Analyze provider billing practices by utilizing code auditing software, provider documentation, administrative policies, regulatory codes, legislative directives, precedent, AMA and CMS code edit criterion

• Review medical records to ensure billing is consistent with medical record for appeals, adjustments and miscellaneous/unlisted code review

• Review cases with Medical Director to validate decisions and identify opportunities to create medical policy in the absence of guidelines

• Assist with research of health plan coding questions

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Qualification & Experience

• Required: Associate’s degree in related field or equivalent experience

• Required: Coding Certification - CPC, CPC-H, CPC-A, CPC-P, CCS, CCS-P, CPMA, RHIT or RHIA

• Preferred: CPC, CPC-P, CCS, CCS-P

• Required: Coding certification and 2+ years of experience in medical billing & coding, coding/data analysis, accounting/business or physician/hospital data management or RN/LPN and 2+ years of related clinical experience

• Preferred: Experience in provider communication and education

• Disqualifiers:

  • Less than 2 years’ experience

  • Lack of certification

  • Inability to work with technology hardware and software applications

  • Not dependable

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Additional Information

Additional qualities to look for: Experience in provider communication and education preferred. Positive attitude, growth mindset, and work well with change. Partnership approach, Critical Thinking.

Top 3 must-have hard skills stack-ranked by importance:

1. Analyze provider billing practices by utilizing code auditing software, provider documentation, administrative policies, regulatory codes, legislative directives, precedent, AMA and CMS code edit criterion. Identify potential billing errors, abuse, and fraud.

2. Operate technological hardware (laptop, pc) and work in software applications

3. Written and verbal communication
   
    

   Candidate Requirements
   Education/Certification	Required: Associate’s degree in related field or equivalent experience. Coding Certification - CPC, CPC-H, CPC-A, CPC-P, CCS, CCS-P, CPMA, RHIT or RHIA			Preferred: CPC, CPC-P, CCS, CCS-P
   Licensure	Required: Associate’s degree in related field or equivalent experience.  Coding certification and 2+ years of experience in medical billing & coding, coding/data analysis, accounting/business or physician/hospital data management or RN/LPN and 2+ years of related clinical experience.  Experience in provider communication and education preferred.			Preferred: N/A
   Years of experience required: 2+ years of experience in medical billing & Coding Disqualifiers: Less than 2 years’ experience. Lack of certification. Inability to work with technology hardware and software applications. Not dependable.   Additional qualities to look for: Experience in provider communication and education preferred. Positive attitude, growth mindset, and work well with change. Partnership approach, Critical Thinking.
   Top 3 must-have hard skills stack-ranked by importance		1	Analyze provider billing practices by utilizing code auditing software, provider documentation, administrative policies, regulatory codes, legislative directives, precedent, AMA and CMS code edit criterion. Identify potential billing errors, abuse, and fraud.
   		2	Operate technological hardware (laptop, pc) and work in  software applications
   		3	Written and verbal communication

 
 
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 30.00/hr.