Job Title: Medical Coder
Location: Remote
Type: Contract
Interview Process: 1 Round (MS Teams)Job Description: We are seeking an experienced
Medical Coder - Quality Assurance professional to support a high-volume urgent care provider. This role will focus heavily on
Evaluation & Management (E/M) coding review, pre-payment claim audits, and medical record adjudication.
The ideal candidate must have strong QA experience in medical coding and be comfortable reviewing large volumes of claims in a fast-paced environment.
Qualification: - Minimum 2 years of Quality Assurance experience in medical coding
- Active CPC (Certified Professional Coder) certification
- Strong expertise in Evaluation & Management (E/M) coding
- Experience working within a medical records system
- Proficiency in Microsoft Excel
- Ability to manage high-volume workloads with strong attention to detail
Key Responsibilities - Perform quality assurance reviews on medical coding, with a strong focus on Evaluation & Management (E/M) services
- Review and audit medical records to ensure coding accuracy and compliance with medical standards
- Conduct pre-payment claim reviews
- Respond to adjudication of claims (approve or reject as appropriate)
- Analyze high-volume claim submissions (approximately 10,000 claims from a single provider)
- Review paper-based claims that are scanned into the system due to provider deviations from electronic submission standards
- Utilize the Conduit system to access and review medical records
- Document findings and track reviews using Excel and internal systems
- Collaborate with internal teams to ensure regulatory compliance and coding accuracy