Certified Medical Coder - Claims Validation & Review

Firstsource; United States; Hybrid; USD 43,000 - 52,000; Full time

Job summary

Firstsource in Puerto Rico is seeking an experienced Certified Professional Coder (CPC) to support medical record reviews and coding validation for U.S. healthcare clients.

The role involves reviewing documentation for claim disputes and ensuring codes comply with ICD-10-CM, CPT, HCPCS, CMS, HIPAA, and payer guidelines. The position requires bilingual English/Spanish and a commitment to accuracy and confidentiality.

Qualifications

• Certification CPC or CCS/CCA from AAPC/AHIMA.
• Minimum 2 years professional medical coding experience.
• Call center experience required.
• Experience with US healthcare reimbursement, medical record review, and various payers.
• Proficient in ICD-10-CM, CPT, HCPCS, medical terminology, anatomy & physiology, and EHR systems.
• Associate degree in HIM, Medical Coding, or related field.
• Excellent verbal and written communication; bilingual English/Spanish.
• Availability for rotating 8-hour shifts; Mon-Fri 8:00 a.m.–11:00 p.m.; weekends/holidays may be required.

Responsibilities

• Review medical records and validate diagnosis and procedure codes.
• Ensure coding complies with ICD-10-CM, CPT, HCPCS, CMS, HIPAA, and payer guidelines.
• Review claim denials, appeals, audits, and coding disputes; identify opportunities for more specific diagnosis coding.
• Document coding decisions and collaborate with providers and operations staff.
• Maintain coding accuracy, productivity, and confidentiality of PHI.

Skills

Medical coding

Bilingual (English/Spanish)

Verbal and written communication

MS Office proficient

Education

Associate degree in Health Information Management

Tools

ICD-10-CM

CPT

HCPCS

EHR systems (Epic, MEDITECH, eClinicalWorks, 3M Encoder)

Microsoft Office

Job description

Firstsource in Puerto Rico is seeking an experienced Certified Professional Coder (CPC) to support medical record reviews and coding validation for U.S. healthcare clients.

The role involves reviewing documentation for claim disputes and ensuring codes comply with ICD-10-CM, CPT, HCPCS, CMS, HIPAA, and payer guidelines. The position requires bilingual English/Spanish and a commitment to accuracy and confidentiality.