The future of payment integrity.
Medical Coder
Location
United States
Posted
94 days ago
Salary
$90K - $115K / year
Seniority
Mid Level
Job Description
Medical Coder
Machinify
• Audit patient medical records using clinical, coding, and payer guidelines to ensure accurate reimbursement. • Provide clear, evidence-based rationale for code recommendations or reconsiderations to providers or payers. • Collaborate with team leaders to ensure thorough review of DRG denials. • Conduct audits in alignment with organizational quality and timeliness standards. • Use proprietary auditing systems proficiently to make consistent determinations and generate audit letters. • Recommend improvements to the audit system to enhance efficiency. • Ensure compliance with HIPAA regulations for protected health information. • Perform other duties as assigned.
Job Requirements
- An associate or bachelor’s degree in nursing (active/unrestricted license); or in health information management is required.
- Work experience may be considered in lieu of formal education at leadership discretion.
- Certification (at least one of the following is required): RHIA - Registered Health Information Administrator, RHIT- Registered Health Information Technician, CCDS - Certified Clinical Documentation Specialist, CDIP - Clinical Documentation Improvement Practitioner, CCS - Certified Coding Specialist, CIC - Certified Inpatient Coder.
- Inpatient claims auditing, quality assurance or recovery auditing experience of 2 years or more required, and/or Inpatient Clinical Documentation Integrity experience of 2 years or more required.
- Strong focus on quality and attention to detail.
- Deep curiosity and analytical skills to understand root causes of events and behaviors.
- Proven ability to apply critical judgment in clinical and coding determinations.
- In-depth knowledge of clinical criteria and documentation requirements to support code assignments.
- Expertise in DRG methodologies (e.g., MS & APR).
- Expertise in ICD-10-CM/PCS coding, UHDDS definitions, Official Coding Guidelines, and AHA’s Coding Clinic Guidelines.
- Ability to work independently and efficiently with minimal supervision.
Benefits
- Work from anywhere in the US! Machinify is digital-first.
- Top Medical/Dental/Vision offerings
- FSA/HSA
- Tuition reimbursement
- Competitive salary, 401(k) with company match
- PTO
- Additional health and wellness benefits and perks
- Flexible and trusting environment where you’ll feel empowered to do your best work
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