JOB SUMMARY
The Certified Medical Coding Specialist is responsible for reviewing denied medical claims, correcting coding and billing errors, and preparing claims for timely resubmission. This is a temporary, part-time position (20 hours per week for approximately four months) supporting revenue cycle operations. The position offers a hybrid work schedule with flexible hours and the potential to transition to a fully remote arrangement based on performance.
DUTIES AND RESPONSIBILITIES
- Review payer denials and determine the reason for denial.
- Research medical records, coding, payer policies, and billing guidelines.
- Correct CPT, HCPCS, ICD-10-CM, modifiers, and other claim elements as appropriate.
- Prepare corrected claims and supporting documentation for resubmission.
- Work with billing staff to resolve complex claim issues.
- Identify denial trends and communicate recurring issues to leadership.
- Maintain productivity and quality standards while meeting filing deadlines.
- Document all actions taken in the practice management system.
- Perform other revenue cycle duties as assigned.
QUALIFICATIONS
EDUCATION
- Current CPC, CCS, or equivalent coding certification required.
EXPERIENCE
- Minimum of 2 years of professional medical coding experience; denial management experience preferred.
- Strong knowledge of ICD-10-CM, CPT, HCPCS Level II, and payer billing requirements.
- Experience with electronic health records and practice management systems; eClinicalWorks experience preferred.
- Excellent analytical, organizational, and problem-solving skills.
- Ability to work independently with minimal supervision.
- Strong written and verbal communication skills.
- Proficiency in Microsoft Office, particularly Excel.
WORKING CONDITIONS
- Part-time: 20 hours per week.
- Duration: Approximately 4 months.
- Hybrid work environment with flexible scheduling.
- Potential for fully remote work over time based on performance and business needs.
PHYSICAL REQUIREMENTS
- Regular use of a computer and keyboard.
- Ability to remain seated for extended periods with occasional standing and walking.