Certified Professional Coder

Thecarolinascenter; Remote; USD 55,000 - 75,000; Part time

Job summary

A healthcare consultancy firm is seeking a Certified Professional Coder (CPC) in Raleigh, NC. The role involves reviewing provider service documentation against billed claims to ensure compliance with regulatory standards. Ideal candidates will possess a CPC certification and significant experience in DRG coding, alongside strong communication and data management skills. We offer competitive compensation and a flexible work environment.

Benefits

Competitive salary

Flexible work environment

Qualifications

• Certified Professional Coder certification with at least two years’ experience in DRG coding in inpatient facility.
• Experience in medical or dental field with familiarity of documents and processes.
• Basic understanding of statistics and data management.

Responsibilities

• Review and compare provider service documentation to billed claims to ensure compliance.
• Perform reviews in accordance with contract requirements for accuracy.

Skills

Reviewing provider service documentation

Compliance with clinical policies

Excellent communication skills

Data management

Education

Associate or bachelor's degree in a human services field

Tools

Microsoft Suite

SharePoint

Job description

Certified Professional Coder, Independent Contractor

Constellation Quality Health is a non‑profit health care quality consultancy and QIO‑like Entity certified by Centers for Medicare and Medicaid Services (CMS) founded by physicians in 1983. Headquartered in North Carolina’s Research Triangle, we offer an array of quality improvement, clinical review, audit, technical, and consulting services and solutions to improve care delivery, system performance, and patient outcomes.

What You’ll Do

The Certified Professional Coder (CPC) is responsible for reviewing and comparing provider service documentation to billed claims in order to determine compliance with clinical policies, state and federal regulations.

• Perform reviews in a manner consistent with contract requirements for timeliness and accuracy.

Our requirement for this role:

• Associate or bachelor’s degree required in a human services field or five (5) years of related experience may substitute for degree.
• Certified Professional Coder certification with at least two (2) years’ experience in DRG coding in inpatient facility setting. CIC (Certified Inpatient Coder Certification) preferred.
• Experience in medical or dental field with familiarity of documents and processes.
• Proficiency in Microsoft Suite (Word, Excel, PowerPoint, Outlook, PowerBI, etc.), web platforms, and SharePoint.
• Experience in Quality Improvement and implementation of Corrective Action Plans preferred.
• Excellent communication skills, both written and oral.
• Basic understanding of data management and statistics.

Why Constellation Quality Health

We offer a competitive salary and a flexible work environment.

Equal opportunity employer of protected veterans.

Equal opportunity employer of individuals with disabilities.

We do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, gender identity, national origin, medical condition, disability, veteran status, or any other basis protected by law.

Applicants and employees are protected from discrimination based on inquiring about, disclosing, or discussing compensation or the compensation of other applicants or employees.