Medical Coder

ExamWorks; United States; Remote; USD 34,000 - 55,000; Part time

Job summary

ExamWorks is seeking experienced Certified Professional Coders (CPCs) to perform remote medical coding reviews in support of Federal IDR cases under No Surprises Act. This role involves analyzing complex billing documentation and delivering code-level insights within set deadlines.

The Medical Coding Reviewer will assess itemized bills, DRG/APC assignments, and QPA validity, ensuring neutrality and accuracy in every review. Remote, flexible opportunity for experienced coders across the US.

Qualifications

• Active CPC credential through AAPC required.
• Minimum of 3 years coding/claims experience.
• CCS, COC, CRC or other credentials are a plus.
• Experience with out-of-network billing or revenue.
• Strong knowledge of medical coding and claims documentation.
• Ability to work independently and meet deadlines.
• Ability to maintain neutrality and provide objective analysis.
• No conflicts of interest with providers or payers as required under Federal IDR

Responsibilities

• Review itemized bills, coding documentation, and payments submitted by disputing parties.
• Assess coding accuracy and supporting documentation.
• Review DRG and APC assignments.
• Assess the validity of the Qualifying Payment Amount (QPA).
• Identify coding discrepancies or other billing issues.
• Provide clear, code-level analysis to support the IDRE’s determination.
• Complete assigned reviews within required turnaround times.

Skills

CPC credential

3+ years experience

DRG/APC knowledge

Neutrality

Job description

Are you a Certified Professional Coder (CPC's) looking to supplement your income in a flexible, remote, nonclinical setting?

Then let me introduce you to ExamWorks medical peer review services!

We are seeking experienced Certified Professional Coders (CPCs) to perform remote medical coding reviews in support of Federal Independent Dispute Resolution (IDR) cases under the No Surprises Act.

This opportunity is ideal for experienced medical coders who are comfortable independently reviewing complex billing and coding documentation and providing detailed, code-level analysis within established turnaround times.

What You’ll Do

As a Medical Coding Reviewer, you will review documentation submitted by both parties involved in Federal IDR payment disputes. Your analysis will help inform the Independent Dispute Resolution Entity’s (IDRE) payment determination.

Responsibilities include:

• Review itemized bills, coding documentation, and payment remittance submitted by disputing parties
• Assess coding accuracy and supporting documentation
• Review DRG and APC assignments
• Assess the validity of the Qualifying Payment Amount (QPA)
• Identify coding discrepancies or other relevant billing issues
• Provide clear, code-level analysis to support the IDRE’s payment determination
• Complete assigned reviews within required turnaround times

Requirements – What We’re Looking For

• Active Certified Professional Coder (CPC) credential through AAPC required
• Minimum of 3 years of coding and/or claims experience
• CCS, COC, CRC, or other relevant coding credentials are a plus
• Experience with out-of-network billing, payment adjudication, or revenue
• Strong knowledge of medical coding, billing practices, and claims documentation
• Ability to work independently and meet firm deadlines
• Ability to maintain neutrality and provide objective analysis
• No conflicts of interest with applicable providers, healthcare facilities, or payers, as required under Federal IDR requirements