Coder - Medical Review (Remote)
Coder - Medical Review (Remote)
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Integrity Management Services Inc. (IntegrityM) is a woman-owned small business specializing in assisting government healthcare organizations prevent and detect fraud and abuse in their programs.
At IntegrityM we offer a culture of opportunity recognition and collaboration. We thrive off of these fundamental elements that make IntegrityM a great place to work. We offer the flexibility our employees need to challenge themselves and focus on advancing their professional development and careers. Large company perks. Small company feel.
Job Title: Coder - Medical Review
Location: Remote
Employment Type: Full-Time Part-Time PRN
Reports To: Team Lead or Project Manager
Position Overview
The Coder assigns accurate compliant ICD-10-CM CPT HCPCS and ICD-10-PCS codes across inpatient outpatient and physician settings. This role supports utilization review coding validation and testing and quality assurance. Works with project teams to maintain coding accuracy manage work queues and ensure the integrity of medical review and policy enforcement.
Key Responsibilities
- Apply expertise in ICD-10 CPT HCPCS and ICD-10-PCS coding across inpatient outpatient professional and facility settings.
- Review medical documentation to ensure accurate compliant coding in accordance with organizational payer and regulatory requirements.
- Collaborate with data scientists clinicians and policy experts to provide coding input for AI/ML model development and improvement.
- Support quality assurance through coding audits peer reviews utilization reviews and clinical documentation improvement.
- Maintain confidentiality and comply with all privacy security and training requirements.
- Participate in team meetings training and continuing education to stay current with industry updates.
- Achieve and maintain quality accuracy and productivity metrics while exercising sound judgment in applying company policies.
Requirements
Qualifications
- Minimum of one (1) year of professional (non-internship) experience in medical coding for general acute care hospital (inpatient and outpatient) and multi-specialty physician settings
- Certified/credentialed through an organization such as AHIMA or AAPC (e.g. RHIT CCS CPC CCA or other applicable certification) required
- Proficient in applying ICD-10-CM Coding Guidelines and interpreting Official Coding Clinics
- Familiarity with CPT HCPCS and ICD-10-PCS coding systems
- Strong attention to detail and ability to meet productivity and quality benchmarks
- Ability to work independently and as part of a distributed team in a remote setting
- Effective communication and collaboration skills
Preferred Qualifications
- Experience with managed care or commercial insurance
- Experience or exposure to Medicare and/or Medicaid
Employment Type
Full Time
