Medical Reviewer, Coder - Seasonal

J29, Inc; Oregon; Híbrido; USD 48.000 - 55.000; Jornada completa

Descripción de la vacante

J29, Inc. is seeking a Medical Reviewer, Coder for a temporary seasonal assignment of up to six months. The role is remote, with an hourly rate of $35–$40.

You will review Medicare FFS claims to identify overpayments and ensure correct payments under CMS rules. You’ll apply National and Local Coverage Determinations, document findings, and support quality assurance through audits and training. The ideal candidate has extensive medical coding or billing experience and familiarity with Medicare

Formación

• 5+ years direct medical coding or medical billing in a healthcare setting.
• 3+ years in a productivity-based claims or case-working environment.
• 3+ years remote work with various technology systems.
• Medicare Fee-For-Service (FFS) experience preferred.

Responsabilidades

• Review Medicare FFS claims for overpayments, underpayments and proper payments per RAC guidance.
• Apply National and Local Coverage Determinations and CMS rules.
• Document clear, accurate findings for each claim.
• Support quality assurance through audits and ongoing training; maintain CMS privacy standards.

Conocimientos

Medical coding

Medical billing

Remote work

Medicare FFS experience

Low-code / No-code tools

Educación

AAPC/AHIMA certification

RHIA/RHIT credentialing

Herramientas

Low-code/no-code case management

Descripción del empleo

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

Medical Reviewer, Coder

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.