Medical Coding Specialist (Outpatient / Profee)
Insight Global is seeking a fully remote medical coding specialist to support a healthcare AI client. This part-time, fully remote opportunity requires candidates to leverage their outpatient coding expertise to evaluate and improve AI-driven coding recommendations. This role is highly analytical and requires a strong understanding of outpatient coding guidelines, reimbursement logic, and payer rules across specialties. Laptop and equipment will be provided. Shift times: Flexible scheduling to work within Monday-Friday, 9am-8pm PST (can't work weekends) (must be available 10-20 hours/week from 9am-8pm PST // ideal for individuals seeking additional income).
Responsibilities:
- Review outpatient encounters and evaluate AI-generated coding recommendations across settings such as same-day surgery, observation, ED, clinic, and ancillary services
- Assess the accuracy and reasoning behind assigned CPT/HCPCS codes, modifiers, APC groupings, and LCD/NCD compliance
- Identify discrepancies where AI-selected codes, modifiers, or APC assignments differ from correct coding practices and explain the rationale
- Provide insight into coding decision-making, including modifier sequencing, bundling rules, and payer-specific nuances
- Share outpatient coding expertise with internal product teams to improve AI logic and recommendations
- Partner with GTM teams to critique coding-related presentations and provide subject matter expertise