Medical Reviewer, Coder - Seasonal

J29, Inc; Millersville (MD); Remote; USD 48,000 - 55,000; Part time

Job summary

J29, Inc. is seeking a Medical Reviewer, Coder for a temporary seasonal role conducted remotely. The position involves reviewing Medicare FFS claims to determine proper payments and identify overpayments or underpayments, aligned with RAC guidance.

Applicants should have 5+ years of medical coding/billing experience, 3+ years in a productivity-based environment, and strong familiarity with CMS rules. Remote work is supported and collaboration with CMS-compliant processes is expected.

Qualifications

• 5+ years direct medical coding or medical billing experience in a healthcare environment.
• 3+ years working in a productivity-based claims or case working environment, out of a queued case management system.
• 3+ years working remotely with various technology systems; Medicare FFS experience in a medical coding role is preferred.
• Experience with low-code, no-code case management systems as an end-user is preferred but not required.

Responsibilities

• RVC Reviewers perform automated and complex reviews of Medicare FFS claims, including Part A/B, DMEPOS, and Home Health/Hospice to assess overpayments, underpayments, and proper payments as determined by RACs.
• They apply CMS policies and guidelines, ensuring claims are evaluated according to National and Local Coverage Determinations and CMS rules, and document clear, accurate findings for each claim.
• Reviewers participate in dispute resolution by re-examining claims and providing supporting documentation, support QA through audits and ongoing training, and maintain CMS security and privacy standards.

Skills

Medical coding

Remote work

Claims processing

Policy adherence

Education

AAPC/AHIMA certification

Job description

Medical Reviewer, Coder

This is a temporary seasonal position. Employment is anticipated to continue for up to six months based on business needs.

Location: Remote

Rate: $35-40 hourly

About J29

At J29, we believe in empowering our employees to do great things for the benefit of others. Our culture is built on purpose, service, and impact - not just for our clients, but for our communities. We are a mission-driven, people-first organization that believes strong culture, thoughtful leadership, and meaningful philanthropy are inseparable from business success.

Key Responsibilities

RVC Reviewers perform both automated and complex reviews of Medicare Fee-for-Service (FFS) claims- including Part A/B, DMEPOS, and Home Health/Hospice to assess overpayments, underpayments, and proper payments as determined by Recovery Audit Contractors (RACs). They apply Medicare policies and guidelines, ensuring claims are evaluated according to National and Local Coverage Determinations and CMS rules, and document clear, accurate findings for each claim.

Reviewers participate in dispute resolution by re-examining claims and providing supporting documentation, support quality assurance through audits and ongoing training, and maintain compliance with CMS security and privacy standards. They also collaborate closely with key personnel to ensure consistency, accuracy, and continuous process improvement in all review activities.

Qualifications

• 5+ years of direct medical coding or medical billing experience, specifically in a healthcare environment.
• 3+ years working in a productivity-based claims or case working environment, out of a queued case management system.
• 3+ years working remotely with various technology systems. Ideally, candidate will have 3+ years of Medicare Fee For Service (FFS) experience in a medical coding role or program.
• Experience with low-code, no-code case management systems as an end-user is preferred but not required.

Education/Certification

• Certified from an accredited association such as the American Association of Professional Coders (AAPC) or American Health Information Management Association (AHIMA). May also be Registered Health Information Administrators (RHIA) and Registered Health Information Technicians (RHIT); credentialed by AHIMA in their field of health information