Certified Medical Coder

TAG MedStaffing; New York (NY); On-site; USD 60,000 - 80,000; Full time

Job summary

TAG MedStaffing in New York seeks an experienced Certified Medical Coder to support a 90-day coding quality and claims optimization project in New York. You will review and validate claims, audit AI recommendations, ensure ICD-10/CPT/HCPCS accuracy, and collaborate with tech teams to improve billing workflows and denial reduction.

This hands-on role requires current certification and deep knowledge of modifiers, revenue cycle processes, and documentation standards.

Qualifications

• Current professional medical coding certification.
• Strong knowledge of ICD-10-CM, CPT, HCPCS, and modifiers.
• Experience reviewing and validating medical claims.
• Experience identifying coding errors and documentation deficiencies.
• Knowledge of medical billing, claim submission, denials, and revenue cycle workflows.
• Experience conducting coding audits or quality reviews.
• Ability to interpret provider documentation and determine appropriate coding.

Responsibilities

• Review and validate corrected medical claims prior to submission.
• Audit AI-generated coding recommendations for accuracy.
• Verify ICD-10, CPT/HCPCS codes and modifiers against documentation.
• Identify coding errors, documentation deficiencies, and missed opportunities.
• Provide recommendations to correct coding and billing issues.
• Perform claim audits and track coding trends.
• Analyze claim holds and denials to identify root causes.
• Help establish quality checkpoints before claim submission.
• Support revenue cycle and billing workflow improvements.
• Collaborate with tech/vendor teams to test AI coding recommendations.
• Educate billing staff on coding validation and documentation requirements.

Skills

ICD-10-CM

CPT

HCPCS

Modifiers

Claims validation

Revenue cycle

Auditing

Documentation interpretation

AI coding

Job description

We are seeking an experienced Certified Medical Coder to support a 90-day coding quality and claims optimization project. This role will review and validate medical claims, audit AI-generated coding recommendations, identify coding and documentation discrepancies, and help improve billing workflows and coding accuracy. The ideal candidate has strong hands-on knowledge of ICD-10, CPT, HCPCS, modifiers, claim validation, and medical billing workflows.

Key Responsibilities

• Review and validate corrected medical claims prior to submission
• Audit AI-generated coding recommendations for accuracy
• Verify ICD-10 diagnosis codes, CPT/HCPCS procedure codes, and modifiers against provider documentation
• Identify coding errors, documentation deficiencies, and missed coding opportunities
• Provide recommendations to correct coding and billing issues
• Perform random and targeted claim audits
• Track coding errors, trends, and recurring issues
• Analyze claim holds and coding-related denials to identify root causes
• Help establish quality checkpoints before claim submission
• Review Athena revenue cycle and work queue processes
• Identify opportunities to improve charge capture, claim review, and billing workflows
• Collaborate with technology/vendor teams to test and validate coding recommendations
• Provide feedback to improve the accuracy of AI-assisted coding
• Assist with coding procedures, reference materials, and SOP development
• Educate billing staff on coding validation, documentation requirements, and coding best practices

Required Qualifications

• Current professional medical coding certification
• Strong knowledge of ICD-10-CM, CPT, HCPCS, and modifiers
• Experience reviewing and validating medical claims
• Experience identifying coding errors and documentation deficiencies
• Knowledge of medical billing, claim submission, denials, and revenue cycle workflows
• Experience conducting coding audits or quality reviews
• Ability to interpret provider documentation and determine appropriate coding

Preferred Qualifications

• Experience with coding quality assurance or compliance auditing
• Experience training or coaching medical billing/coding staff
• Experience working with AI-assisted or automated medical coding technology
• Experience analyzing claim holds, denials, and work queues

Benefits / Highlights

• Approximately 90-day contract assignment
• Opportunity to work on a coding quality and AI optimization initiative
• Hands-on involvement in improving coding accuracy and revenue cycle workflows

Contract Length: Approximately 90 days

Schedule: Monday–Friday, 9:00 AM–5:00 PM