REMOTE Medical Coding Specialist - 260311

Medix Staffing Solutions, Inc.; United States; Remote; USD 34,000 - 55,000; Part time

Job summary

Medix Staffing Solutions, Inc. is seeking an ophthalmology medical coder and billing specialist to review clinical documentation, assign CPT/HCPCS/ICD-10-CM codes, and ensure accurate E/M visit levels.

You will collaborate with ASC staff to verify procedures and code facility charges, and assist with pre-authorization coding. The role involves processing charges for submission to insurers and patients, while staying current with payer rules and HIPAA requirements.

Qualifications

• 3+ years of ophthalmology medical coding and billing experience.
• Active CPC or CPOC certification.
• Strong knowledge of CPT/HCPCS/ICD coding systems, visit levels (E/M), modifiers, bundling edits, and general medical billing practices.

Responsibilities

• Review clinical documentation to assign and sequence CPT, HCPCS Level II, and ICD-10-CM codes for professional and facility charges.
• Apply modifiers, correct visit levels, and ensure coding compliance with payer rules.
• Collaborate with ASC staff to verify procedures and code facility charges.
• Assist with CPT/HCPCS/ICD coding for pre-authorization of services.
• Process and prepare charges for submission to insurers and patients.

Skills

CPT coding

HCPCS Level II

ICD-10-CM coding

E/M visit levels

Modifiers & bundling edits

Medical billing basics

HIPAA compliance

Education

High school diploma or equivalent

CPC or CPOC certification

Job description

• Review clinical documentation to accurately assign and sequence CPT, HCPCS Level II, and ICD-10-CM codes for professional and facility charges (clinic visits, office-based services, ASC surgeries, optical services, and durable medical equipment).
• Apply appropriate modifiers, correct visit levels (E/M), and diagnosis-to-procedure linkages to ensure compliance with NCCI bundling edits and payer rules.
• Collaborate with ASC surgical staff to verify actual procedures performed and code facility charges accordingly.
• Assist with the assignment of CPT, HCPCS, and ICD-10 codes for pre-authorization of services.
• Process, balance, and prepare charges for timely submission to insurance carriers and patient billing.

Auditing, Clinical Documentation Improvement & Provider Education

• Monitor and track incomplete encounters to ensure all clinical documentation is completed timely and prior to code finalization; query physicians regarding outstanding documentation needs.
• Read, interpret, and audit medical charts in accordance with organizational protocol to identify documentation improvement trends and compliance risks.
• Develop tailored educational materials and present audit findings, coding updates, and documentation procedures to physicians and clinical staff.
• Serve as an internal subject-matter resource for coding, documentation integrity, and medical necessity rules.

Edits, Denials & Revenue Cycle Support

• Resolve pre-claim submission edits and work queues assigned to coding to facilitate clean, timely claim processing.
• Support billing and AR teams with reviewing previously coded charges, resolving coding-related claim denials, and preparing formal appeals.
• Stay current with insurance regulations, legislative updates, and payer policy changes; communicate relevant updates to management in a timely manner.
• Attend departmental meetings and participate in ongoing educational activities to keep skills and credentials up to date.
• Maintain patient confidentiality in strict compliance with HIPAA, state, federal, and company regulations.
• Proactively identify, report, and participate in resolving any potential or actual patient safety concerns, while supporting overall clinic workflow efficiency.

Requirements

• Education: High school graduate or high school equivalency credential.
• Experience: Minimum 3 years of Ophthalmology medical coding and billing experience.
• Credentials: Active coding certification (CPC or CPOC)
• Coding & Billing Knowledge: Working knowledge of CPT, HCPCS, and ICD coding systems, visit levels (E/M), modifiers, bundling edits, and general medical billing practices.
• Chart Review & Auditing: Proven ability to read, interpret, and audit complex medical records against clinical documentation standards.

Schedule/Shift: Flexible schedule for 25-30 hours a week between M-F 8am-5pm EST

**Can sit in any state except AK, CA or HI**