Coder I - Billing & Audit - FT - Days - MSS - Hybrid Eligible
Core
Reviews medical record documentation to assign diagnosis, procedure, and modifier codes ensuring proper billing and compliance.
Role type
Medical Coder (Billing & Audit)
Builds
Accurate medical billing submissions and audit reports for hospital and physician billing.
Domain
Healthcare / Health Information Management
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Medical terminology, anatomy and physiology, coding classification systems (CPT, ICD), encoder software, CMS regulations, Local Medical Review Policy (LMRP), Ambulatory Payment Classifications (APC), Enhanced Ambulatory Patient Groups (EAPG), Local Coverage Determination (LCD)
Preferred skills
HCC Coding Hierarchical Condition Category, surgical coding, diagnostic/procedural office coding
Technologies
Electronic medical record systems, encoder software
Responsibilities
Review medical record documentation to determine appropriate diagnosis and procedural code assignments; assign and sequence basic CPT procedure codes and modifiers; communicate with insurance companies about coding errors and disputes; conduct audits and coding reviews with healthcare professionals; validate accuracy of data in Admission, Discharge Transfer (ADT) fields; submit daily productivity reports.
Seniority
Entry-level to Junior, individual contributor