Certified Professional Coder

• Perform Level of Service audits on medical bills to validate coding accuracy and appropriateness.
• Review and interpret complex medical documentation including office visits consultations surgeries and hospitalservices.
• Apply CPT ICD-10 and HCPCS coding standards to ensure proper billing and reimbursement.
• Ensure compliance with state-specific fee schedules Workers Compensation regulations and payer guidelines.
• Identify and resolve discrepancies in coding and documentation.
• Respond to provider appeals and inquiries with clear regulation-based explanations.
• Collaborate with internal teams including customer service billing and compliance to resolve coding issues.
• Maintain up-to-date knowledge of coding guidelines regulatory changes and industry best practices.
• Protect the confidentiality of patient and provider information.
• Participate in ongoing training and maintain active CPC certification and required CEUs.

• Experience with multi-state jurisdictional regulations.
• Understanding of Usual & Customary PPO discounts and non-fee schedule claims.
• Minimum 2 years of experience in medical coding preferably in Workers Compensation or medical bill review.
• Background in hospital billing guidelines for inpatient and outpatient services.
• Prior experience in level of service auditing or clinical documentation improvement (CDI).
• CPC (Certified Professional Coder) certification required; CCS or CPC-A considered with relevant experience.
• Strong knowledge of CPT ICD-10 HCPCS and medical terminology.
• Familiarity with CompIQ Solutions or similar bill review platforms preferred.
• Excellent analytical communication and problem-solving skills.
• Ability to work independently and manage multiple priorities in a fast-paced environment.

All qualified applicants will receive consideration for employment without regard to race color religion gender gender identity sexual orientation national origin ethnicity age disability marital status or any other characteristic protected by law.

Genfinity as an Equal Opportunity Employer believes in each persons potential and well help you achieve yours.

All information will be kept confidential according to EEO guidelines.

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