Medical Coder II/III
CodaMetrix
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $75,000 - $115,000 per year
About the role
- Serve as the internal and external Subject Matter Expert (SME) on medical coding and billing across assigned service lines.
- Review and validate model-generated CPT, ICD-10-CM, HCPCS, and E&M codes
- Perform high-quality coding and auditing on inpatient, outpatient, ED, or pro-fee encounters (depending on specialty)
- Ensure documentation fully supports coding decisions in alignment with AMA, CMS, and payer guidelines
- Identify missed codes, incorrect E/M leveling, modifier errors, and insufficient documentation
- Analyze and document customers’ coding practices and workflows to facilitate optimal use of the CodaMetrix product.
- Identify and share Codametrix’s best practices for coding automation and workflow improvements with the customer.
- Present audit results to customer stakeholders and facilitate sign-off for go-live milestones.
- Assist manager with Coding Quality Assessment (CQA) projects, including work assignments, training, and quality assurance for offshore coding staff.
- Leverage CodaMetrix coding standards to drive world-class coding quality and consistency.
- Work with product and engineering to provide precise, consistent feedback on model training and data annotation
- Continuously improve evaluation and training materials on coding and billing to colleagues and customers.
- Share knowledge throughout CodaMetrix to build internal competencies and champion continuous improvement initiatives.
- Provide expert guidance on coding and billing questions to support Machine Learning and Product teams.
- Proactively stay up to date with changes in medical coding and billing by maintaining relevant certifications and participating in ongoing education.
- Uphold all legal and ethical requirements, ensuring accuracy, confidentiality, and compliance in all coding and audit activities.
- Help explain model decisions, error analyses, and coding rationales to clients
- Support customer success and implementation teams in understanding coding outputs
- Prepare clear written summaries of coding patterns, documentation issues, or model behavior
- Collaborate with cross-functional teams—such as Data Science, Product, and Customer Success—to address client needs and optimize results.
Requirements
- Current AHIMA or AAPC coding credential held for 3+ (level II) or 5+ years (level III).
- 3-5 (level II) or 5+ years (level III) of coding and auditing experience with progressive growth in responsibilities.
- Strong understanding of CPT, ICD-10-CM, HCPCS, modifiers, and 2023 E/M guidelines
- Experience in one of the following specialties: Professional hospital coding; specifically in Surgery, Endoscopy, Hospitalist, Cardiology, Emergency coding
- Demonstrated ability to interpret clinical documentation and identify gaps
- Excellent communication and customer service skills, capable of effectively engaging executives, directors, data scientists, and other stakeholders with varying levels of coding knowledge.
- Ability to translate complex coding guidelines to non-clinical team members.
- Strong organizational and detail-oriented approach with a demonstrated commitment to excellence and precision.
- Critical thinking, intellectual curiosity, and creativity in problem-solving.
- Ability to thrive under time constraints in a fast-paced environment.
- Team-oriented approach with a positive and patient demeanor, fostering collaboration and continuous improvement.
Benefits
- Health Insurance: We cover 80% of the cost of medical and dental insurance and offer vision insurance
- Retirement: We offer a 401(k) plan that eligible employees can contribute to one month after their first day
- Flexibility: We have a generous Paid Time Off policy, which is managed but not limited, so you can take the time you need to relax and rejuvenate
- Learning: All new hires complete our 7-week Onboarding Program where they learn about our company and each of our departments through live sessions hosted by a variety of our leaders
- Development: We provide annual performance evaluations and prioritize working with employees on what their individual growth looks like
- Recognition: We recognize the outstanding achievements of our team through annual company awards where employees have the opportunity to nominate their peers
- Office Location: A modern open plan workspace located in the bustling Back Bay neighborhood of Boston
- Additional Employer Paid Benefits: We offer employer-paid life insurance and short-term and long-term disability insurance
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
medical codingbillingCPT codesICD-10-CM codesHCPCS codesE&M codescoding auditingcoding quality assessmentcoding automationdata annotation
Soft Skills
communication skillscustomer service skillsorganizational skillsdetail-orientedcritical thinkingproblem-solvingteam-orientedcollaborationcreativityadaptability
Certifications
AHIMA coding credentialAAPC coding credential