Remote Medical Coding Reviewer

Centene Corporation; United States; Remote; USD 50,000 - 70,000; Full time

Job summary

A healthcare organization is seeking a Medical Coding Reviewer I to perform medical claim reviews, ensuring compliance with coding practices. Candidates should have an Associate's degree, coding certification, and at least 2 years of experience in medical coding. Strong analytical skills and attention to detail are essential for success in this role.

Qualifications

• Associate's degree in a related field or equivalent experience.
• Coding certification and 2+ years in medical billing & coding or related fields.
• Experience in provider communication and education preferred.

Responsibilities

• Perform clinical/coding medical claim review to ensure compliance.
• Analyze provider billing practices and review medical records for consistency.
• Identify potential billing errors, abuse, and fraud while maintaining records.

Skills

Medical coding proficiency

Clinical analysis

Attention to detail

Education

Associate's degree in a related field

Tools

Coding certification

Job description

A company is looking for a Medical Coding Reviewer I.

Key Responsibilities

• Perform clinical/coding medical claim review to ensure compliance with coding practices
• Analyze provider billing practices and review medical records for consistency with billing
• Identify potential billing errors, abuse, and fraud while maintaining appropriate records

Required Qualifications, Training, and Education

• Associate's degree in a related field or equivalent experience
• Coding certification and 2+ years of experience in medical billing & coding or related fields
• Experience in provider communication and education preferred
• Licensure as LPN, RN, or relevant coding certifications (e.g., CPC, CCS)
• 2+ years of related clinical experience