Medical Director - Clinical Coding & Compliance

Paycom - ATS; Baltimore (MD); On-site; USD 240,000 - 280,000; Full time

Benefits offered by this job

Competitive compensation

Benefits package

Job summary

RELI Group seeks a Medical Director to represent the firm and its federal partners, focusing on fraud prevention and coding edits. You will guide coders, resolve complex medical-record issues, and contribute to contract compliance and educational material development.

The role requires MD/DO, board certification, and extensive Medicare/Medicaid policy knowledge, with strong communication skills and the ability to collaborate across levels in a contracting environment.

Qualifications

• MD/DO license in at least one US state with no sanctions
• Board certification for at least 3 years in a BIS-recognized specialty
• Experience interpreting HCPCS/CPT and coding conventions

Responsibilities

• Represent RELI Group and partners on federal contracts
• Contribute to fraud prevention via PTP, MUE and AOC edits
• Provide clinical guidance to coders and resolve complex medical-record issues
• Prepare research documents and educational materials
• Provide clinical and coding training to contract staff

Skills

HCPCS/CPT coding

Medicare/Medicaid policy

Clinical documentation

Contract compliance

Written & verbal communication

Education

Doctor of Medicine or Osteopathy

Tools

Coding resources

Job description

RELI Group seeks a Medical Director to represent the firm and its federal partners, focusing on fraud prevention and coding edits. You will guide coders, resolve complex medical-record issues, and contribute to contract compliance and educational material development.

The role requires MD/DO, board certification, and extensive Medicare/Medicaid policy knowledge, with strong communication skills and the ability to collaborate across levels in a contracting environment.