Certified Medical Coding Specialist
Summary
A part-time, temporary role reviewing denied medical claims, correcting coding errors, and resubmitting claims for a healthcare provider, using medical coding standards like CPT, HCPCS, and ICD-10-CM.
JOB SUMMARY
The Certified Medical Coding Specialist is responsible for reviewing denied medical claims, correcting coding and billing errors, and preparing claims for timely resubmission. This is a temporary, part-time position (20 hours per week for approximately four months) supporting revenue cycle operations. The position offers a hybrid work schedule with flexible hours and the potential to transition to a fully remote arrangement based on performance.
DUTIES AND RESPONSIBILITIES
- Review payer denials and determine the reason for denial.
- Research medical records, coding, payer policies, and billing guidelines.
- Correct CPT, HCPCS, ICD-10-CM, modifiers, and other claim elements as appropriate.
- Prepare corrected claims and supporting documentation for resubmission.
- Work with billing staff to resolve complex claim issues.
- Identify denial trends and communicate recurring issues to leadership.
- Maintain productivity and quality standards while meeting filing deadlines.
- Document all actions taken in the practice management system.
- Perform other revenue cycle duties as assigned.