Medical Review Coder Specialist – Medicare

🔥 17 hours ago

🇺🇸 United States – Remote

💵 $28 - $43 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Empower AI

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1989

🎖️ Defense

🏥 Healthcare

📦 Logistics

Defense • Healthcare • Logistics

Empower AI, formerly known as NCI, is a company that enhances the capabilities of public sector teams through advanced artificial intelligence solutions. With a focus on federal agencies, Empower AI leverages its extensive technical expertise to address complex challenges in both Civilian and Defense missions, enabling government leaders to boost workforce productivity and make informed decisions quickly. The company's offerings encompass a range of specialties, including AI, cybersecurity, software development, and cloud migration, aimed at facilitating meaningful transformation within government operations.

📋 Description

• Review and analyze sampled Medicare claims using associated medical records • Make payment determinations based on coding and practice guidelines • Make coding determinations using AHA Coding Clinic for ICD-9-CM, ICD-10-CM/PCS, AHA Coding Clinic for HCPCS, and AMA CPT Assistant • Analyze medical records to validate ICD-10-CM, ICD-10-PCS, CPT-4, HCPCS II coding, and MS-DRG assignment on acute inpatient hospital and outpatient claims • Review codes, diseases, conditions, and procedures on acute inpatient hospital records • Review clinical documentation to ensure assigned codes are appropriately supported • Conduct in-depth claims analysis using ICD-10-CM, CPT-4, and HCPCS Level II coding principles • Use electronic health information imaging and enter coding review decisions into the electronic database module from grouper for inpatient DRG claims • Use internet and intranet sources for policy verification • Use Microsoft Office and other software templates as source input for claims review • Meet quality and production standards • Ensure departmental compliance with the quality management system and ISO requirements

🎯 Requirements

• Bachelor's degree or equivalent combination of education and experience • Active Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) certification • One of the following certifications preferred: CCS-P, CPC, or COC • RHIA or RHIT certification listed as an alternative qualification • Minimum of four years of experience in inpatient, acute care coding for Medicare reimbursement • MS-DRG assignment experience and encoder experience • ICD-10-CM/PCS coding experience • Ability to maintain strict confidentiality of sensitive material • Must be able to meet home-office security requirements if approved for remote location • Must pass a coding test prior to hiring in Part A DRG Medicare inpatient MS-DRG • Ability to sit for long periods

🏖️ Benefits

• Recognized as a 2024 Military Friendly Employer • Hiring and supporting active-duty and veteran employees • Remote work arrangement, subject to approval and home-office security requirements