The Judge Group
Job Title:
Senior Medical Coder Job Type:
Contract to Hire Location:
Fully Remote Hours:
8:00 AM - 5:00 PM (Monday - Friday) Rate:
$25.00/hourly
Position Summary This position serves as the company’s expert in medical billing codes and code‑edit content, supporting ongoing development and improvement of the 4L FWA Prevention™ Solution. The role ensures accurate application of diagnosis, procedure, and episode‑of‑care coding to support compliant reimbursement and payment accuracy. Responsibilities include staff management, quality oversight, compliance monitoring, and cross‑functional collaboration with internal teams and customers.
Duties and Responsibilities Serve as the company expert on medical billing codes and code‑edit applications. Analyze and apply coding guidelines to product solutions. Stay current with CMS inpatient and outpatient coding guidelines. Validate CMS‑related code edits within the 4L FWA Prevention™ Solution. Develop coding and editing strategies using Integr8 AI Risk Detection™ technology in collaboration with business and technical teams. Support customers and internal teams with day‑to‑day coding and code‑edit implementation. Review medical records to identify and assign diagnosis and procedure codes using ICD‑10‑CM and ICD‑10‑PCS. Ensure accurate assignment of diagnoses, procedures, and modifiers. Assign Present on Admission (POA) indicators and group inpatient cases into the appropriate MS‑DRG. Understand coding scenarios that impact Patient Safety Indicators (PSIs). Maintain HIPAA compliance at all times. Follow CMS coding guidelines and OIG regulations. Maintain knowledge of applicable federal, state, and local laws, company policies, and ethical standards.
Skills and Knowledge Experience in the healthcare or insurance industry is preferred, including familiarity with: HIPAA and healthcare data protection requirements Claims adjudication, EMR/EHR workflows, or related systems Payment integrity or fraud, waste, and abuse (FWA) initiatives Medical coding and claims‑editing tools Claims data formats (such as 835 and 837) Provider network management, credentialing, or data integrity Fraud detection or Special Investigations Unit (SIU) activities 4L Data Intelligence Knowledge
Education and Experience Bachelor’s degree, or Associate degree with at least ten (10) years of medical coding experience. Coding and/or fraud investigation certifications preferred.
Senior Medical Coder Job Type:
Contract to Hire Location:
Fully Remote Hours:
8:00 AM - 5:00 PM (Monday - Friday) Rate:
$25.00/hourly
Position Summary This position serves as the company’s expert in medical billing codes and code‑edit content, supporting ongoing development and improvement of the 4L FWA Prevention™ Solution. The role ensures accurate application of diagnosis, procedure, and episode‑of‑care coding to support compliant reimbursement and payment accuracy. Responsibilities include staff management, quality oversight, compliance monitoring, and cross‑functional collaboration with internal teams and customers.
Duties and Responsibilities Serve as the company expert on medical billing codes and code‑edit applications. Analyze and apply coding guidelines to product solutions. Stay current with CMS inpatient and outpatient coding guidelines. Validate CMS‑related code edits within the 4L FWA Prevention™ Solution. Develop coding and editing strategies using Integr8 AI Risk Detection™ technology in collaboration with business and technical teams. Support customers and internal teams with day‑to‑day coding and code‑edit implementation. Review medical records to identify and assign diagnosis and procedure codes using ICD‑10‑CM and ICD‑10‑PCS. Ensure accurate assignment of diagnoses, procedures, and modifiers. Assign Present on Admission (POA) indicators and group inpatient cases into the appropriate MS‑DRG. Understand coding scenarios that impact Patient Safety Indicators (PSIs). Maintain HIPAA compliance at all times. Follow CMS coding guidelines and OIG regulations. Maintain knowledge of applicable federal, state, and local laws, company policies, and ethical standards.
Skills and Knowledge Experience in the healthcare or insurance industry is preferred, including familiarity with: HIPAA and healthcare data protection requirements Claims adjudication, EMR/EHR workflows, or related systems Payment integrity or fraud, waste, and abuse (FWA) initiatives Medical coding and claims‑editing tools Claims data formats (such as 835 and 837) Provider network management, credentialing, or data integrity Fraud detection or Special Investigations Unit (SIU) activities 4L Data Intelligence Knowledge
Education and Experience Bachelor’s degree, or Associate degree with at least ten (10) years of medical coding experience. Coding and/or fraud investigation certifications preferred.