We are seeking an experienced Certified Medical Coder to support a 90-day coding quality and claims optimization project. This role will review and validate medical claims, audit AI-generated coding recommendations, identify coding and documentation discrepancies, and help improve billing workflows and coding accuracy. The ideal candidate has strong hands-on knowledge of ICD-10, CPT, HCPCS, modifiers, claim validation, and medical billing workflows.
Key Responsibilities
Review and validate corrected medical claims prior to submission
Audit AI-generated coding recommendations for accuracy
Verify ICD-10 diagnosis codes, CPT/HCPCS procedure codes, and modifiers against provider documentation
Identify coding errors, documentation deficiencies, and missed coding opportunities
Provide recommendations to correct coding and billing issues
Perform random and targeted claim audits
Track coding errors, trends, and recurring issues
Analyze claim holds and coding-related denials to identify root causes
Help establish quality checkpoints before claim submission
Review Athena revenue cycle and work queue processes
Identify opportunities to improve charge capture, claim review, and billing workflows
Collaborate with technology/vendor teams to test and validate coding recommendations
Provide feedback to improve the accuracy of AI-assisted coding
Assist with coding procedures, reference materials, and SOP development
Educate billing staff on coding validation, documentation requirements, and coding best practices
Required Qualifications
Current professional medical coding certification
Strong knowledge of ICD-10-CM, CPT, HCPCS, and modifiers
Experience reviewing and validating medical claims
Experience identifying coding errors and documentation deficiencies
Knowledge of medical billing, claim submission, denials, and revenue cycle workflows
Experience conducting coding audits or quality reviews
Ability to interpret provider documentation and determine appropriate coding
Preferred Qualifications
Experience with coding quality assurance or compliance auditing
Experience training or coaching medical billing/coding staff
Experience working with AI-assisted or automated medical coding technology
Experience analyzing claim holds, denials, and work queues
Benefits / Highlights
Approximately 90-day contract assignment
Opportunity to work on a coding quality and AI optimization initiative
Hands-on involvement in improving coding accuracy and revenue cycle workflows
Contract Length: Approximately 90 days
Schedule: Monday–Friday, 9:00 AM–5:00 PM
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