Freelance Medical & Billing Coder

Dane Street; Town of Florida (NY); On-site; USD 60,000 - 85,000; Full time

Job summary

Dane Street is hiring coders, bill reviewers, and payment integrity reviewers to join our team. The role focuses on applying clinical knowledge to ensure accurate medical billing and coding, and to communicate with office teams to address questions and meet client deadlines.

Core duties include evaluating codes, matching records to codes, applying policy guidelines, and providing QA oversight for complex cases. Strong customer service and timely delivery are essential.

Qualifications

• Proficient in medical coding and billing review practices.
• Strong understanding of healthcare terminology and coding guidelines.
• Ability to interpret clinical information and apply coding standards.

Responsibilities

• Evaluates the appropriateness of codes and determines whether they meet program standards.
• Ensures medical records align with codes or obtains missing records.
• Reads and applies policy guidelines and healthcare terminology to determine criterion satisfaction.
• Evaluates claims for conflict of interest and criterion appropriateness.
• Adheres to established timeframes set by program parameters.
• Delivers excellent customer service and coordinates with clients on quality assurance of cases.
• Provides clinical oversight to complex cases prior to client return.
• Serves as a QA resource for cases with quality issues.

Skills

Medical coding

Billing review

Healthcare terminology

Job description

Calling all bill review professionals, CPC coders, AAPC, and DRG coders! Dane Street is looking for highly motivated Coders, bill reviewers, and payment integrity reviewers candidates to join our team. Dane Street offers an exciting work environment, competitive compensation, and strong growth potential.

Job Summary: A new program offering on the group health side of our business enables you to apply your clinical knowledge to review reports accompanying medical records to ensure that medical billing information and coding are correct. You will communicate with other reviewers and their office teams to ensure clarity of information and ensure all questions posed have been addressed, and ensure that reports are returned within client deadlines.

Core Duties & Responsibilities

• Evaluates the appropriateness of codes and determine whether they meet all established program standards.
• Ensures that the medical records are matched appropriately to the codes and if not, obtains them.
• Read & apply policy guidelines and healthcare terminology and delineate when criteria are/are not met.
• Evaluates claims for conflict of interest and criteria appropriateness.
• Works within established timeframes set by program parameters.
• Provides strong customer service skills and works closely with clients on a case- by-case basis to provide complete, timely, and error-free quality assurance of cases.
• Provides clinical oversight to cases that are complex and need additional review prior to return to the client.
• Serves as an additional level of QA and clinical knowledge/review for cases with quality Issues.