• Codes more than one of the following: inpatient and/or outpatient hospital records, ED records, Home Health & Hospice records and/or professional fee services for PMG specialty providers for the purpose of reimbursement, research and in compliance with Federal regulation according to diagnosis, operation and procedure using the ICD-9/10 CM and CPT-4 classification system. • Ensures adherence to Hospital and Departmental Policies and Procedures. • Reviews patients' entire current medical record, assigning appropriate codes including CPT, ICD and MS-DRG (as defined by UHDDS guidelines and CMS). • Abstracts data essential to the QI department. • Accesses several systems via the computer to research the medical record when needed to complete the coding in a timely manner. • Takes responsibility for accounts receivable by looking for lost documents to ensure all encounters are coded. • Resolves any and all pre-bill edits, denials, etc for assigned accounts. • Maintains and disseminates up-to-date technical knowledge of legal and regulatory information. • Participates in all departmental in-services and updates to stay current with accepted coding guidelines.

• Contribute to provide excellent care in surrounding communities. • Grow professionally within an excellent patient care environment.

• Perform inpatient coding for medical records • Collaborate with healthcare professionals to ensure accurate coding • Review and analyze clinical documentation for coding compliance

Role Description - Oversee end-to-end medical billing and claims submission operations across professional fee and/or facility billing environments. - Evaluate AI-generated billing outputs, claim edits, and coding validations for accuracy and payer compliance. - Manage claims submission workflows including electronic claim generation, clearinghouse edits, and payer-specific billing requirements. - Monitor clean claim rates, rejection rates, and first-pass acceptance rates. Develop improvement strategies. - Coordinate with coding, CDI, and collections teams to resolve billing edits and claim rejections. - Ensure compliance with CMS billing guidelines, HIPAA 837 transaction standards, and payer-specific billing rules. - Annotate AI outputs and provide structured feedback to support AI training datasets. Qualifications - Must-Have: - 5+ years of experience in medical billing and claims management, with at least 2 years in a management role. - Deep knowledge of professional fee (CMS-1500/837P) and/or facility (UB-04/837I) billing requirements. - Expertise in HIPAA 837 transaction standards, clearinghouse operations, and payer-specific billing rules. - Strong understanding of Medicare, Medicaid, and commercial payer billing requirements. - Proficiency with billing platforms (Epic, Athenahealth, AdvancedMD, or equivalent) and clearinghouse tools. - Exceptional written and verbal English communication skills. - High attention to detail with the ability to identify billing errors and compliance issues in AI-generated outputs. - Preferred: - CPC, CCS, CHFP, or CRCR certification. - Experience with automated billing platforms and RCM technology implementations. - Background in multi-specialty physician group, hospital, or health system billing operations. - Familiarity with AI tools and comfort evaluating AI-generated billing content. - Experience with payer contract interpretation and billing compliance program management. Application Process - Upload resume - AI interview based on your resume - Submit form Resources & Support - For details about the interview process and platform information, please check: Interview Process - For any help or support, reach out to: support@mercor.com - Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.