Medical Coding Reviewer III, CPC, RHIT/RHIA Required

CareSource

Program Integrity Medical Coding Reviewer analyzing complex medical claims and supporting medical record audit programs. Collaborating with cross department teams to increase performance and compliance in coding.

Posted 7/14/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $62,700 - $100,400 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in medical billing and coding, with a strong focus on compliance with state and federal laws, and the ability to lead training initiatives and process improvements. Proficient in generating detailed reports and analyses to enhance performance tracking and provider support.

Highest-signal resume keywords

Medical Billing And Coding ExperienceClaim Pre-Payment AuditingMedicaid/Medicare ExperienceReimbursement Methodology (APC, DRG, OPPS)Leadership Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical BillingMedical CodingClaim AuditingPerformance ReportingProcess ImprovementTraining DevelopmentInpatient CodingSIU/FWA ExperienceDocumentation AuditingReimbursement Methodology

Soft Skills

Leadership AbilityCommunication SkillsProblem-Solving Skills

Tools & Technologies

Facets

Industry Keywords

State And Federal LawsBilling GuidelinesProvider Escalation Support

About the role

Key responsibilities & impact

Support most complex medical record audit programs
Generate concise in-depth reporting and analysis to track performance
Provide Provider Pre Pay production and progress reports
Recommend process or procedure changes
Demonstrate leadership ability
Identify knowledge gaps and provide training opportunities
Serve as a primary resource for provider escalation support
Maintain a working knowledge of all state and federal laws, rules, and billing guidelines

Requirements

What you’ll need

Associates degree required
Five (5) years of medical billing and coding experience
Minimum of three (3) years of SIU/FWA medical billing and coding experience required
Prior experience with claim pre-payment, medical claim and documentation auditing required
Medicaid/Medicare experience required
Three (3) years of experience in Facets preferred
Experience with reimbursement methodology (APC, DRG, OPPS) required
Inpatient coding experience preferred
Leadership experience preferred

Benefits

Comp & perks

Health insurance
Retirement plans
Paid time off
Flexible work arrangements
Professional development
Bonuses
Comprehensive total rewards package