Remote Medicare Coding Auditor

DaMar Staffing; United States; On-site; USD 70,000 - 100,000; Full time

Job summary

Commence is seeking a Certified Coder to perform remote, coding-only medical reviews for Medicare Part A/B and DMEPOS, applying ICD-10-CM/PCS, CPT/HCPCS, and DRG/APR-DRG rules.

You will research NCDs/LCDs, document determinations, and help identify improper payments while maintaining HIPAA compliance and case-tracking documentation. This role requires independence, strong attention to detail, and adherence to privacy requirements in a remote, technology-driven environment.

Qualifications

• 3+ years of medical coding, billing or auditing in healthcare with ICD-10-CM/PCS, CPT/HCPCS and DRG/APR-DRG.
• Active coding certification through AAPC or AHIMA (CPC, CCS, CCS-P, CRC, RHIA or RHIT).
• Ability to work remotely in a queue-based claims review environment.
• Knowledge of HIPAA, PHI and CMS privacy/security requirements.
• Associate's degree or equivalent experience accepted in lieu of degree.

Responsibilities

• Perform coding-only medical reviews on Medicare Part A/B and DMEPOS claims applying coding rules.
• Research and apply NCDs, LCDs and CMS guidance to render determinations.
• Identify improper payments and coding errors for referral consideration.
• Maintain claim review documentation in the designated case tracking system.
• Support re-review and provider education sessions as requested.
• Maintain accuracy scores and complete annual trainings including HIPAA compliance.

Skills

Medical coding experience

Coding certification

HIPAA/compliance

CMS guidelines knowledge

Education

Associate's degree or equivalent

Job description

Commence is seeking a Certified Coder to perform remote, coding-only medical reviews for Medicare Part A/B and DMEPOS, applying ICD-10-CM/PCS, CPT/HCPCS, and DRG/APR-DRG rules.

You will research NCDs/LCDs, document determinations, and help identify improper payments while maintaining HIPAA compliance and case-tracking documentation. This role requires independence, strong attention to detail, and adherence to privacy requirements in a remote, technology-driven environment.