Independent Medical Coding and Billing Reviewers

iMPROve Health is seeking certified medical coders as independent contractors to review documentation including medical claims to assist with making eligibility determinations as part of the Independent Dispute Resolution process. The medical coder will analyze documentation to verify the coding and billing of diagnoses, procedures, and treatments.

Reviewer Benefits

• Use your clinical knowledge to improve the quality of health care.
• Join a pool of professionals who are experts in their specialties.
• Benefit from competitive compensation.
• Receive complete confidentiality.
• Enjoy the convenience of reviewing cases remotely.

Reviewer Duties

• Review documentation, including medical codes, providing expertise that guides eligibility determination recommendations.
• Comply with and assess claims for appropriate diagnoses and procedure codes, using ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) and CPT (Current Procedural Terminology), HCPCS Level II (Healthcare Common Procedure Coding System).
• Ensure previously billed codes are accurate and sequenced correctly in accordance with government and insurance regulations.
• Adhere to all relevant compliance regulations (HIPAA, FISMA, URAC, CMS).

Required Qualifications

• Associate degree or higher
• Minimum of 3 years of medical coding and billing experience
• Coding Certification (CPC, CCS, or CMC) and/or Billing Certification (CPB)
• Working knowledge of medical terminology and anatomy
• Strong verbal and written communication skills
• Experience with technological systems
• Proficient in Microsoft Office Suite software

Preferred Qualifications

• Understanding/experience of the No Surprises Act a plus
• Other specialized medical coding certifications, such as Certified Professional Medical Auditor (CPMA), or Evaluation and Management (CEMC)
• Experience with remote work environments