Remote Medical Coder – ICD-10-CM, RADV & HCC

ePATHUSA, Inc.; Clive (IA); Remote; USD 70,000 - 90,000; Full time

Benefits offered by this job

Remote work

Training opportunities

Job summary

ePATHUSA, Inc. is seeking an experienced Medical Coder to support CMS RADV review efforts by validating medical record documentation, abstracting diagnoses, and ensuring ICD-10-CM coding accuracy in accordance with CMS requirements.

The ideal candidate will maintain a 95% accuracy rate, work remotely, and meet productivity targets while documenting determinations in the CDAT-M system and complying with HIPAA and CMS data-use terms.

Qualifications

• Active, valid coding certification from AHIMA or AAPC (CPC/COC/CIC/CRC/CCA/CCS).
• Minimum of 2 years professional coding experience with ICD-10-CM.
• Experience coding across hospital inpatient, hospital outpatient, and physician office settings.
• Ability to pass a federal background check and obtain CMS security clearance.
• Remote work readiness for a fully remote CMS RADV contract in the US.

Responsibilities

• Perform intake review of medical records to ensure CMS RADV readiness.
• Abstract diagnoses in ICD-10-CM per CMS-approved RADV workflows.
• Evaluate documentation against CMS-HCC model requirements.
• Utilize CMS-approved coding tools (e.g., 3M Encoder) for accuracy.
• Document determinations in CDAT-M per SOP; escalate complex issues.
• Meet productivity targets and maintain 95% accuracy.
• Attend CMS/RADV training sessions and stay current with guidance.
• Handle PHI in compliance with HIPAA and data-use agreements.

Skills

Attention to detail

Produce accurate coding under metrics

Remote work adaptability

Education

AHIMA or AAPC certification (CPC/COC/CIC/CRC/CCA/CCS)

Tools

CDAT-M platform

CMS-approved tools

Job description

ePATHUSA, Inc. is seeking an experienced Medical Coder to support CMS RADV review efforts by validating medical record documentation, abstracting diagnoses, and ensuring ICD-10-CM coding accuracy in accordance with CMS requirements.

The ideal candidate will maintain a 95% accuracy rate, work remotely, and meet productivity targets while documenting determinations in the CDAT-M system and complying with HIPAA and CMS data-use terms.