Remote Certified Medical Coder – Medicare Claims Expert

Commence, LLC; Virginia, Northern (IL, KY); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Commence is seeking a Remote Medical Coding Reviewer to perform coding-focused reviews of Medicare Part A/B and DMEPOS claims. You will verify ICD-10-CM, CPT, and HCPCS codes, ensure medical necessity, and document findings in the case-tracking system.

Qualified candidates have 3+ years of coding experience, active AAPC/AHIMA certification, and the ability to work independently in a remote setting while maintaining HIPAA compliance. A data-driven mindset and attention to detail are essential.

Qualifications

• 3+ years of direct experience in medical coding, medical billing, and/or coding quality assurance/auditing in a healthcare environment
• Active coding certification through AAPC or AHIMA: CPC, CCS, CCS-P, CRC, RHIA, or RHIT
• Ability to research and document coding determinations per CMS guidance
• Remote work ability in a queue-based claims review environment
• HIPAA and PHI/PII compliance knowledge
• Associate's degree or equivalent combination of certs/experience

Responsibilities

• Perform coding-only medical reviews on Medicare Part A/B and DMEPOS claims
• Research and apply NCDs, LCDs, and CMS coding guidance to document determinations
• Identify improper payments, coding errors, and documentation patterns for referrals
• Maintain claim review documentation in the case tracking system
• Support provider education sessions and re-review as needed
• Maintain individual accuracy scores per company standards

Skills

Medical coding

HIPAA compliance

Coding accuracy

Documentation

Remote work

Education

Associate's degree

Tools

CMS case management system

Low-code/no-code platforms

Job description

Commence is seeking a Remote Medical Coding Reviewer to perform coding-focused reviews of Medicare Part A/B and DMEPOS claims. You will verify ICD-10-CM, CPT, and HCPCS codes, ensure medical necessity, and document findings in the case-tracking system.

Qualified candidates have 3+ years of coding experience, active AAPC/AHIMA certification, and the ability to work independently in a remote setting while maintaining HIPAA compliance. A data-driven mindset and attention to detail are essential.