Medical Coder

Nexus HR Services; Franklin Park (IL); Remote; USD 10,000 - 60,000; Part time

Job summary

A leading company is seeking experienced Medical Coders for a remote position. You will provide accurate coding services for Medicare, Commercial, and Medicaid lines. Responsibilities include coding medical records, maintaining quality standards, and adhering to compliance guidelines. Ideal candidates will have a strong coding background and relevant certifications.

Qualifications

• Minimum of 4 years of medical coding experience.
• Deep understanding of CMS ICD-10-CM Official Guidelines.

Responsibilities

• Assign appropriate ICD-10-CM codes to diagnoses and procedures.
• Maintain a minimum of 98% monthly coding quality accuracy.
• Follow HIPAA guidelines and protect all patient information.

Skills

Attention to Detail

Coding Proficiency

Documentation

Education

CPC or CRC Certification

CCS or CCA Certification

Job description

Medical Coder - Remote

Compensation: $18-$20 hourly DOE

Employment: 1099

** Overview: Nexus HR is looking for experienced and certified Medical Coders to provide accurate, compliant, and high-quality coding services for one of our prestigious clients in the healthcare industry. This is a remote opportunity supporting risk adjustment coding for Medicare, Commercial, and Medicaid lines of business. Coders will work with clinical documentation and use client applications to extract ICD-10-CM codes while maintaining high standards of accuracy and compliance.**

About the Job

The Medical Coder will be responsible for reviewing medical records and assigning appropriate ICD-10-CM codes for risk adjustment purposes. Coders will work on different projects throughout the coding season, including first-pass coding, submission review, and quality assurance. All coders are expected to maintain minimum quality and production benchmarks and will follow both client and industry coding guidelines.

Duties and Responsibilities:

• Assign appropriate ICD-10-CM codes to diagnoses and procedures in accordance with CMS/HHS and client-specific guidelines.

• Work across Medical, Commercial, and Medicaid Risk Adjustment projects.

• Use client-provided Application Services to code and maintain necessary documentation for rebuttal and quality control.

• Review all Dates of Service (DOS) to capture relevant risk-adjustable or all appropriate diagnoses based on the client’s selected Coding Approach (Best DOS or All DOS).

• Assign issue flags at the Medical Record, Diagnosis, and DOS levels for documentation issues.

• Participate in Submissions Review for higher-level approval of ICD-10-CM codes flagged for submission.

• Maintain a minimum of 98% monthly coding quality accuracy, with removal from the project if accuracy drops below 95% for two consecutive months.

• Submit daily production reports comparing volume coded to the daily target.

• Input required data simultaneously in client systems to ensure traceability and quality rebuttals.

• Follow HIPAA guidelines and protect all patient information.

• TLs, SMEs, and Managers must ensure adherence to TAT and take accountability for the team’s coding quality.

• Complete annual compliance training (HIPAA, Fraud, Waste & Abuse, Privacy & Security) and attest to reading client coding and ethics policies.

Qualifications :

• Minimum of 4 years of medical coding experience.

• Must demonstrate coding proficiency and knowledge.

• Licenses/Certifications (Required):

• AAPC (minimum CPC or CRC) OR

• AHIMA (minimum CCS or CCA)

• Certifications must be current and not apprentice-level.

• Deep understanding of CMS ICD-10-CM Official Guidelines, AHA’s Coding Clinic, and risk adjustment principles.

• Ability to use NLP/Computer Assisted Coding tools (preferred).

• Excellent attention to detail, accuracy, and documentation.

• Ability to meet daily/weekly productivity and quality targets.

• Risk adjustment coding for Medicare, Commercial, and Medicaid lines of business.

• Compliance with client coding approaches and documentation standards.

• Proficient in English (reading and written communication required).

• Must be authorized to work in the United States.