Remote Medical Coder & Audit Specialist

ADP, Inc.; Avondale (LA); Remote; USD 55,000 - 75,000; Full time

Job summary

InclusivCare is seeking a Medical Coder (Remote) to provide coding, audit, and compliance support for all clinical services. The role ensures accurate code assignment and adherence to FQHC billing requirements, Medicare, Medicaid, and payer policies while supporting risk mitigation through provider education.

Minimum three years of professional medical coding experience with an AAPC certification is required; experience in an FQHC or community health center is preferred.

Qualifications

• AAPC Coding Certification required. A minimum of three (3) years of professional medical coding experience is required.
• Experience in a Federally Qualified Health Center or community health center setting is recommended.
• Ongoing training related to FQHC coding, payer policy updates, and regulatory compliance are required annually.

Responsibilities

• Conduct routine and targeted provider coding audits to ensure compliance with FQHC billing requirements, Medicare, Medicaid, and commercial payer policies.
• Analyze audit findings and communicate results to Providers, including corrective action recommendations and education as needed.
• Serve as a liaison to Providers regarding coding updates, documentation standards, and regulatory changes; must be able to present effectively to physician groups.
• Review all coding-related denials to identify trends, root causes, and systemic risks; recommend preventive strategies to reduce future denials.
• Review Athena coding rejections and validate relevance to FQHC encounters, eliminating non-applicable or payer-inaccurate edits.
• Collaborate with Billing Specialists to identify coding risks, compliance concerns, and documentation gaps that may impact reimbursement.
• Ensure appropriate use of CPT, HCPCS, ICD-10-CM, and FQHC-specific codes in accordance with payer and regulatory guidance.
• Prepare compliance, audit, and denial trend reports for the Revenue Cycle Manager and leadership.
• Travel to InclusivCare locations as needed to support onsite audits, provider education, or operational needs.
• Ensure compliance with HIPAA and all applicable federal and state regulations governing patient health information.

Skills

Medical coding

Audit & compliance

Provider education

Excel

Communication

Education

AAPC Coding Certification

3+ years coding experience

Tools

Athena

EHR systems

Job description

InclusivCare is seeking a Medical Coder (Remote) to provide coding, audit, and compliance support for all clinical services. The role ensures accurate code assignment and adherence to FQHC billing requirements, Medicare, Medicaid, and payer policies while supporting risk mitigation through provider education.

Minimum three years of professional medical coding experience with an AAPC certification is required; experience in an FQHC or community health center is preferred.