Medical Coder / CDI

Softechub; United States; On-site; USD 65,000 - 95,000; Full time

Job summary

Softechub is seeking a Medical Coding, CDI, Billing, and Denials specialist with 3 years of experience and credentials such as CCS, CPC, CDIP, or CCDS. You will design high-difficulty clinical tasks, synthesize longitudinal charts, and assess clinical accuracy and safety across diverse care settings.

Responsibilities include rubric scoring, cross-functional review, and escalation for ambiguities, with a focus on quality and payer accuracy.

Qualifications

• 3 years of experience in medical coding, CDI, billing or denials.
• Active professional license or credential where applicable.
• Experience in clinical practice, healthcare operations, medical review, AI evaluation, data annotation, content review or related analytical role is preferred.

Responsibilities

• Clinical Benchmark Authoring & Task Design: Develop high-difficulty clinical tasks, long-chart scenarios, realistic workplace cases, gold-standard answers, and evaluation criteria within the assigned discipline
• Longitudinal Chart Synthesis: Evaluate fragmented, multi-encounter records and identify clinically meaningful trends, contradictions, omissions, risks, and required actions
• Clinical Accuracy & Safety Review: Assess whether outputs are clinically accurate, practical, evidence-aligned, patient-safe, and appropriate for the relevant care setting
• Rubric Application & Scoring: Apply evaluation criteria defined by the Functional SME Lead to assess outputs for clinical reasoning, terminology, documentation quality, regulatory alignment, payer accuracy, and patient-safety implications
• Specialty Task Evaluation: Depending on the assigned area, review tasks involving mobility and discharge planning, swallow and diet-texture recommendations, medical necessity, prior authorization, claims and denials, nutrition support, diabetes management, psychosocial safety, infection…
• Peer Review & Calibration - Senior Track: Review and calibrate pod members’ work, resolve edge-case ambiguities, identify rubric inconsistencies, and maintain day-to-day quality standards
• Cross-Functional Review: Evaluate tasks that require coordination across physicians, nurses, therapists, pharmacists, social workers, dietitians, coders, case managers, payers, laboratory professionals, or emergency personnel
• Iterative Refinement: Incorporate calibration feedback, revise task content and solutions, and participate in multiple critique cycles to align deliverables with project standards
• Escalation & Quality Ownership - Senior Track: Escalate genuine clinical, regulatory, or rubric ambiguities to the Functional SME Lead and support consistent decision-making across the pod
• Bachelor’s degree, graduate degree, professional degree, or equivalent practical experience in a relevant healthcare discipline
• Active professional license, board certification, or recognized industry credential where applicable
• Experience in clinical practice, healthcare operations, medical review, AI evaluation, data annotation, content review, quality assurance, clinical documentation, or a related analytical role is preferred
• Prior experience reviewing expert work, creating clinical education content, developing assessment materials, or participating in quality-improvement programs is advantageous

Skills

3 years of experience

Clinical coding

Education

Bachelor’s degree or higher

Credentials e.g. CCS/CPC/CDIP/CDDS or equivalent

Job description

Medical Coding, CDI, Billing, and Denials. 3 years of experience. Guide: e.g. CCS, CPC, CDIP, or CCDS or equivalent.

Duties

• Clinical Benchmark Authoring & Task Design: Develop high-difficulty clinical tasks, long-chart scenarios, realistic workplace cases, gold-standard answers, and evaluation criteria within the assigned discipline
• Longitudinal Chart Synthesis: Evaluate fragmented, multi-encounter records and identify clinically meaningful trends, contradictions, omissions, risks, and required actions
• Clinical Accuracy & Safety Review: Assess whether outputs are clinically accurate, practical, evidence-aligned, patient-safe, and appropriate for the relevant care setting
• Rubric Application & Scoring: Apply evaluation criteria defined by the Functional SME Lead to assess outputs for clinical reasoning, terminology, documentation quality, regulatory alignment, payer accuracy, and patient-safety implications
• Specialty Task Evaluation: Depending on the assigned area, review tasks involving mobility and discharge planning, swallow and diet-texture recommendations, medical necessity, prior authorization, claims and denials, nutrition support, diabetes management, psychosocial safety, infection…
• Peer Review & Calibration - Senior Track: Review and calibrate pod members’ work, resolve edge-case ambiguities, identify rubric inconsistencies, and maintain day-to-day quality standards
• Cross-Functional Review: Evaluate tasks that require coordination across physicians, nurses, therapists, pharmacists, social workers, dietitians, coders, case managers, payers, laboratory professionals, or emergency personnel
• Iterative Refinement: Incorporate calibration feedback, revise task content and solutions, and participate in multiple critique cycles to align deliverables with project standards
• Escalation & Quality Ownership - Senior Track: Escalate genuine clinical, regulatory, or rubric ambiguities to the Functional SME Lead and support consistent decision-making across the pod
• Bachelor’s degree, graduate degree, professional degree, or equivalent practical experience in a relevant healthcare discipline
• Active professional license, board certification, or recognized industry credential where applicable
• Experience in clinical practice, healthcare operations, medical review, AI evaluation, data annotation, content review, quality assurance, clinical documentation, or a related analytical role is preferred
• Prior experience reviewing expert work, creating clinical education content, developing assessment materials, or participating in quality-improvement programs is advantageous

Required experience

• 3 years of experience
• Active PT, OT, SLP, RN, RD/RDN, LCSW, PharmD, MD, DO, or other applicable professional license.
• Guide: e.g. CCS, CPC, CDIP, or CCDS or equivalent

12 weeks

Hours

Full-time or Part time. 40h or 20h per week with 4 hours PST overlap.

Time-zone overlap

4 hours PST overlap

United States

Application steps

• ICF
• Assessment
• DM review