Remote Medicare Medical Coder - Coding Review Expert

DOMA Technologies; Virginia Beach (VA); On-site; USD 60,000 - 90,000; Full time

Job summary

Commence is seeking a seasoned Medical Coder to perform remote, coding-focused reviews of Medicare Part A/B and DMEPOS claims. You will verify ICD-10-CM/PCS, CPT/HCPCS codes, and DRG/APR-DRG assignments, ensuring accuracy and adherence to CMS rules.

Strong documentation and HIPAA compliance are essential. The ideal candidate has 3+ years in medical coding within healthcare, active AAPC/AHIMA certification, and the ability to research and apply coding guidance in a remote queue environment.

Qualifications

• 3+ years of direct experience in medical coding, medical billing, and/or coding quality assurance in a healthcare environment.
• Active coding certification through AAPC or AHIMA: CPC, CCS, CCS-P, CRC, RHIA, or RHIT.
• Ability to research, apply, and document coding determinations per CMS rules (NCDs/LCDs).
• Ability to work independently in a remote, queue-based claims review environment.
• HIPAA/PHI and privacy compliance knowledge.
• Associate degree or equivalent combination of certification and experience.

Responsibilities

• Perform coding-only medical reviews on Medicare Part A/B and DMEPOS claims, applying ICD-10-CM/PCS, CPT/HCPCS rules.
• Research and apply NCDs, LCDs, and CMS guidance to render and document coding determinations.
• Identify potential improper payments and coding errors for referral consideration.
• Maintain claim review documentation in the case tracking system.
• Support re-review and provider education sessions as requested.
• Maintain individual accuracy scores per company standards.
• Complete annual trainings (ethics, records management, security controls) and HIPAA/PHI compliance.

Skills

Medical coding

HIPAA compliance

Research skills

Documentation

Independent work

Education

Associate degree

Job description

Commence is seeking a seasoned Medical Coder to perform remote, coding-focused reviews of Medicare Part A/B and DMEPOS claims. You will verify ICD-10-CM/PCS, CPT/HCPCS codes, and DRG/APR-DRG assignments, ensuring accuracy and adherence to CMS rules.

Strong documentation and HIPAA compliance are essential. The ideal candidate has 3+ years in medical coding within healthcare, active AAPC/AHIMA certification, and the ability to research and apply coding guidance in a remote queue environment.