Remote Senior Medical Coder & Compliance Specialist

Placements24; Nuwerus; Hybrid; ZAR 900,000 - 1,300,000; Full time

Benefits offered by this job

Health insurance

Dental & Vision coverage

Retirement plan with company match

Generous PTO

Remote work from anywhere

Support for certification maintenance

Job summary

Our client, a global telehealth provider, seeks a Remote Senior Medical Coder & Compliance Specialist to ensure accurate coding and robust regulatory compliance across services. You will lead audits, mentor junior staff, and shape coding policies from a fully remote setting.

Ideal candidates hold CPC/CPB or CCS, 7+ years in coding and auditing, deep ICD-10-CM/CPT/HCPCS knowledge, HIPAA expertise, and strong communication skills for cross-functional collaboration.

Qualifications

• Must hold CPC, CPB, or CCS certification from AAPC or AHIMA.
• 7+ years of medical coding and billing experience with compliance/audit focus.
• Deep knowledge of ICD-10-CM, CPT, and HCPCS Level II.
• Strong HIPAA understanding and regulatory compliance experience.
• Experience in coding audits and giving feedback.
• Excellent analytical and problem-solving skills.
• Strong written and verbal communication for remote collaboration.
• Proficiency with EHR systems and medical billing software.

Responsibilities

• Reviewing and accurately coding diagnoses and procedures (ICD-10-CM, CPT, HCPCS II).
• Conducting regular audits of records and claims for accuracy and compliance.
• Identify and resolve coding/billing discrepancies to reduce denials.
• Developing coding policies, procedures, and best practices.
• Training and mentoring junior coders and staff.
• Staying updated with coding changes and payer policies.
• Collaborating with clinical, billing and compliance teams.
• Performing root cause analysis of coding errors and corrective actions.
• Assisting in developing training materials.
• Serving as SME on coding and compliance matters.

Skills

CPC/CPB/CCS certification

Remote work experience

Auditing

Regulatory knowledge

Education

CPC/CPB/CCS certification

Bachelor’s degree in Health Information Management or related field

Tools

EHR systems

Medical billing software

Job description

About the Role

Our client, a prominent telehealth provider with a global reach, is seeking a highly experienced Remote Senior Medical Coder & Compliance Specialist to join their fully remote operations. This critical role involves ensuring the accuracy and integrity of medical billing and coding across all services, adhering strictly to international coding standards and healthcare regulations. The ideal candidate will possess a deep understanding of complex coding systems (e.g., ICD-10-CM, CPT, HCPCS Level II), regulatory compliance (e.g., HIPAA), and have a proven track record in auditing, training, and process improvement within a remote healthcare environment. You will be instrumental in maintaining compliance, optimizing revenue cycles, and championing best practices in medical coding and billing for our expanding telehealth services. This is an exceptional opportunity to leverage your expertise from anywhere, contributing to the efficient and compliant delivery of healthcare.

Key Responsibilities

• Reviewing and accurately assigning appropriate medical codes (ICD-10-CM, CPT, HCPCS Level II) to diagnoses and procedures based on clinical documentation.
• Performing regular audits of medical records and claims to ensure coding accuracy, completeness, and compliance with payer and regulatory guidelines.
• Identifying and resolving coding and billing discrepancies to minimize claim denials and maximize reimbursement.
• Developing and implementing coding policies, procedures, and best practices for the organization.
• Providing training and mentorship to junior coders and other healthcare staff on coding guidelines and compliance requirements.
• Staying up-to-date with changes in coding systems, healthcare regulations, and payer policies.
• Collaborating with clinical, billing, and compliance departments to address coding-related issues and improve workflows.
• Conducting root cause analysis of coding errors and developing corrective action plans.
• Assisting in the development and maintenance of coding and compliance training materials.
• Serving as a subject matter expert on medical coding and compliance matters.

Requirements

• Certified Professional Coder (CPC), Certified Professional Biller (CPB), or Certified Coding Specialist (CCS) certification from AAPC or AHIMA is mandatory.
• A minimum of 7 years of comprehensive experience in medical coding and billing, with a significant focus on compliance and auditing.
• Extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II coding systems.
• In-depth understanding of healthcare regulations, including HIPAA, and their implications for coding and billing.
• Proven experience in performing coding audits and providing constructive feedback.
• Excellent analytical, problem-solving, and critical-thinking skills.
• Strong communication (written and verbal) and interpersonal skills, essential for remote collaboration.
• Proficiency in electronic health record (EHR) systems and medical billing software.
• Demonstrated ability to work independently and manage workload effectively in a remote setting.
• Bachelor's degree in Health Information Management, Healthcare Administration, or a related field is preferred.

Benefits

• This fully remote position offers a highly competitive annual salary of ** R**, commensurate with experience and certifications.
• Benefits include comprehensive health, dental, and vision insurance, a retirement savings plan with company match, generous paid time off, opportunities for continuous professional development and certification maintenance, and the flexibility to work from any location.

This role provides significant autonomy and the chance to shape compliance standards within a growing telehealth organization.