Terms of Employment:
• W2, Contract
• 3 Months with possible extension
• Predominantly remote. There will be occasional onsite visits to our client’s office in either: Canton, MD, Washington D.C., Owings Mills, MD or Columbia, MD. Candidates must reside within the Maryland, DC, Virginia or Delaware area.
Overview & Responsibilities
Join our client’s Special Investigations Unit (SIU) as a Medical Coder, leveraging your medical coding expertise to combat fraud, waste, and abuse in healthcare claims. This vital role involves the prepayment review of medical records to ensure accurate billing per industry standards and internal policies. You will be instrumental in clearing a significant backlog of claims and contributing to the integrity of the claims process. This is an excellent opportunity for a certified medical coder seeking a high-impact role with potential for long-term employment. Key responsibilities include:
• Review medical records and claims for fraudulent indicators and coding accuracy.
• Determine if claims are accurately billed per industry standards (e.g., AMA guidance, AAPC guidance) and internal payment/medical policies.
• Render determinations on claims, which may include denying or paying them based on review findings.
• Utilize coding software (e.g., Codify, Optum Encoder Pro) or CPT manuals to aid in code review and ensure all required components of office visits are met.
• Manage a high volume of claim reviews, contributing to the reduction of a significant backlog.
Required Qualifications:
• High School Diploma or GED.
• Active and validated Certified Professional Coder (CPC) certification or equivalent accreditation (e.g., CPMA, COC, or AHIMA accreditation) without Apprentice tag.
• 3 years of experience in risk adjustment coding, ambulatory coding, and/or CRC coding experience in managed care, state or federal healthcare programs, or the health insurance industry.
• Experience in physician coding, specifically reviewing office visits and services rendered in a physician's office.
• Proficiency in reviewing medical records and claims for coding accuracy.
• Detail oriented.
Preferred Qualifications:
• Experience using coding software such as Codify (AAPC) or Optum Encoder Pro.
...opportunity allows you to work at your own pace and... ...the comfort of your own home. A Day in the Life... ...Join us today and be part of a dynamic and innovative... ...previous professional experience is required to apply to... ...process. This is a part-time long-term project and...
...maintenance priorities for assigned areas and ensures that quality maintenance is consistently provided in a cost-effective manner. Assist in planning, scheduling and monitoring of daily work assignments either directly or through assigned maintenance staff. Plans and...
...About the Opportunity: Chelsea Piers has developed a learn-to-swim curriculum with classes and private lessons for kids from 6 months... ...our flagship location in Chelsea in a warm-water learn-to-swim pool scheduled to open in summer 2026. We are seeking a Director to implement...
In the Rchling Group youll be shaping industry. Worldwide. Together, we are changing everyday lives by making cars lighter, making drug packaging safer and enhancing industrial applications. With 11,000 employees in 25 countries. In the Automotive division, you will...
...supporting fast-moving project teams Perks & Benefits Hybrid - Enhanced work-life balance with our hybrid model combining both remote and in-office work. Climbing PTO - Enjoy freedom and flexibility with our annual increasing paid time off. Paid Holidays - We...