Certified Coder

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🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🏥 Medical Billing and Coding

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Vytalize Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

🤝 B2B

☁️ SaaS

⚕️ Healthcare Insurance

💰 $100M Series C - Vytalize Health on 2023-02

B2B • SaaS • Healthcare Insurance

Vytalize Health is a healthcare technology and services company that helps primary care practices and Accountable Care Organizations (ACOs) transition to value-based care. It combines data-driven analytics, virtual and in-home clinical support, and care management services to improve patient outcomes, enable Medicare-approved remote services for chronic conditions, and help practices earn shared savings under value-based contracts. Vytalize partners with independent PCPs, group practices, community health centers and existing ACOs to deliver clinical enablement, practice-tailored workflows, and performance insights.

📋 Description

• Review medical record documentation and claim information prior to submission to ensure accurate assignment of ICD-10-CM, CPT, and HCPCS codes, supporting appropriate reimbursement and compliance with regulatory requirements. • Review and analyze coding-related claim denials, underpayments, and payer audit findings to identify root causes and recommend corrective actions that improve reimbursement outcomes. • Research payer policies, coding guidelines, and medical record documentation to support denial appeals, claim corrections, and reconsideration requests when appropriate. • Collaborate with billing and operational teams to resolve coding-related claim issues, reduce recurring denials, and improve first-pass claim acceptance rates. • Monitor coding, billing, and denial trends; prepare reports and collaborate with leadership and operational teams to implement process improvements, coding edits, and workflow enhancements that support compliance and reimbursement optimization. • Stay current on changes to coding regulations, reimbursement methodologies, payer policies, and industry best practices through ongoing education and professional development.

🎯 Requirements

• Two years of experience in medical record coding and denial management. • Strong knowledge of ICD-10-CM, CPT, and HCPCS coding guidelines, medical terminology, anatomy and physiology, and applicable payer, regulatory, and reimbursement requirements. • Proficiency with coding encoder software, electronic medical record (EMR) systems (EPIC experience preferred but not required), Microsoft Office applications, and other healthcare technology platforms. • Knowledge of Medicare, Medicaid, and commercial payer policies, including documentation, coding, reimbursement, and compliance requirements. • Strong analytical and problem-solving skills with the ability to research coding regulations, interpret payer policies, identify root causes of denials, and develop effective solutions. • Ability to review, interpret, and apply complex medical documentation, coding guidelines, policies, procedures, laws, and regulations. • Experience reviewing and resolving coding-related denials, underpayments, and payer audit findings preferred. • Ability to exercise sound independent judgment while maintaining a high degree of accuracy, attention to detail, and professionalism. • Excellent written and verbal communication skills. • Strong interpersonal skills with the ability to build collaborative working relationships with providers, operational leaders, and revenue cycle teams. • Demonstrated commitment to confidentiality, ethical conduct, and compliance with HIPAA and organizational policies. • Certified Professional Coder (CPC) issued by the American Academy of Professional Coders (AAPC) • Certified Coding Specialist (CCS) issued by the American Health Information Management Association (AHIMA) • Registered Health Information Technician (RHIT) issued by the American Health Information Management Association (AHIMA)

🏖️ Benefits

• Competitive base compensation • Health benefits