Medical Coding Specialist (32635)

Exam Works is looking for a Medical Coding Specialist to join our team remotely!

*Must possess current coding certification in CPC. CPMA certification & Certified Life Care Planner certification preferred.

The Medical Coding Specialist (Internally called a Coding Specialist) is responsible to create and write reports based on medical records and appropriate guideline criteria. This position utilizes the system database to determine usual and customary and/or state fee schedule allowances and this position is responsible for analyzing provider billing for proper coding and billing guidelines across all provider types and ensures reviews are completed with highest quality and integrity and that all work is in full compliance with client contractual agreements, regulatory agency standards and/or federal and state mandates.

Schedule for this role is: Monday - Friday 8am-5pm EST

ESSENTIAL JOB FUNCTIONS

• Receive and input client and examinee data in the system database.
• Sort and verify each claim.
• Process and review each claim and address all necessary modifications manually. Contact Client as needed
• Perform quality assurance on every case prior to completion.
• Ensure all medical records and reports are properly documented and saved in the appropriate location and available for audit at all times.
• Process client invoicing in accordance with the client’s fee schedule.
• Handle and responds promptly to incoming calls, emails or faxes from clients requesting report status and/or information.
• Provide notification to the Supervisor of any provider appeals and follow directions as given to resolve the claim.
• Provide testimony in court as to the content of prepared reports, as required. Travel as necessary.
• Ensure all practices are carried out in accordance with HIPAA compliance practices, state and federal safety standards and legal regulations.
• Perform quality assurance on various coding related reviews.
• Perform other duties as assigned.