Remote Medical Coder: Audits, Compliance & Education

InclusivCare; Avondale, Northern (AZ, KY); Hybrid; USD 65,000 - 90,000; Full time

Job summary

InclusivCare is seeking a Medical Coder (Remote) to provide coding, audit, and compliance support for all clinical services. This role ensures accurate CPT/HCPCS/ICD-10-CM coding in line with FQHC regulations and payer policies, while supporting risk mitigation and provider education.

The ideal candidate holds an AAPC Certification and has at least 3 years of professional medical coding experience, preferably in an FQHC setting. Experience with Athena and strong Excel/Word skills are essential.

Qualifications

• AAPC Coding Certification required.
• 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 for job retention.

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, new services, 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.
• Perform other duties as assigned by the Revenue Cycle Manager.

Education

AAPC Coding Certification

Tools

Athena EHR

Microsoft Excel

Microsoft Word

Job description

InclusivCare is seeking a Medical Coder (Remote) to provide coding, audit, and compliance support for all clinical services. This role ensures accurate CPT/HCPCS/ICD-10-CM coding in line with FQHC regulations and payer policies, while supporting risk mitigation and provider education.

The ideal candidate holds an AAPC Certification and has at least 3 years of professional medical coding experience, preferably in an FQHC setting. Experience with Athena and strong Excel/Word skills are essential.