Job Description

Job Description

Job Description

Seeking a highly accurate and detail-oriented Certified Medical Coder (CPC) with experience in Ancillary, specifically within the Workers’ Compensation sector. This role requires strong knowledge of state-specific Workers’ Comp guidelines, payer-specific rules, and prior experience coding services tied to injury-related care. The coder will be responsible for assigning accurate HCPCs codes to ensure compliant billing and optimal reimbursement.

Pay range starts at $50,000+ dependent on experience. Any offer made will be based on the candidate's experience and skill level.

DUTIES AND RESPONSIBILITIES:

• Making sure that codes are assigned correctly and sequenced appropriately as per government and insurance regulations.
• Complying with medical coding guidelines and policies to apply appropriate state-specific Worker’s Compensation rules (including fee schedules and doc requirements)
• Receiving and reviewing orders, contracts and links the data by verifying with accuracy to Provider profiles
• Following up and clarifying any information that is not clear to other staff members
• Implementing strategic processes and choosing strategies and evaluation methods that provide correct results
• Support clean claim submission by proactively identifying and correcting coding issues
• Ensure timely and compliant resubmissions for denials or documentation requests
• Ensure all coding is in compliance with HIPAA, OIG, and industry best practices
• Performs other related duties as assigned by management

QUALIFICATIONS:

• 2-5 years with experience in Healthcare Coding
• High school diploma or general education degree (GED), or one to three months related experience and/or training, or equivalent combination of education and experience.
• Associate's Degree (AA) or equivalent from a two-year college or technical school, or six months to one year related experience and/or training, or equivalent combination of education and experience.
• Certificates, licenses and registrations required: CPC or CCS-P/CCS
• Computer skills required: Microsoft Office (Excel, Word)
• Other skills required: Experience with EHR/EMR systems and billing software (e.g., Kareo, Brightree, or similar), In-Depth knowledge of HCPCS Level II codes

Equal Employment Opportunity Employer

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