The Judge Group
Senior Medical Coder
Location:
Remote Employment Type:
Full-Time
Hours of Operation:
Flexible scheduling required to support global operations. Employees may need to attend pre-scheduled meetings and collaborate with international partners outside normal work hours, including occasional weekends.
About the Role We are seeking a
Senior Medical Coder
to serve as the company’s subject matter expert on medical coding and code-edit content. This role ensures accurate and timely implementation of diagnosis, procedure, and episode-of-care codes to maintain compliance and optimize reimbursement integrity. Responsibilities include staff management, quality assurance, compliance monitoring, and collaboration across teams to enhance payment accuracy and revenue optimization.
Responsibilities Act as the company expert on billing codes and code-edit content, updates, and applications. Analyze, validate, and apply coding guidelines to product solutions. Stay current with CMS coding guidelines for inpatient and outpatient services. Validate CMS-related code edits within proprietary solutions. Develop code-editing strategies using advanced AI technology in collaboration with technical teams. Review and analyze patient medical records to accurately assign ICD-10-CM and ICD-10-PCS codes. Ensure accurate code assignment for diagnoses, procedures, and modifiers. Group diagnoses into MS-DRG and apply POA indicators for inpatient encounters. Understand and apply code assignments that may trigger Patient Safety Indicators (PSI). Maintain HIPAA compliance and adhere to CMS and OIG regulations. Ensure compliance with federal, state, and local laws, as well as company policies and ethical standards.
Required Skills and Knowledge Industry Expertise: Strong understanding of healthcare or insurance industry processes, including: HIPAA compliance and healthcare data protection. Claims adjudication, EMR/EHR workflows. Payment integrity and claims processing (835/837 formats). Medical coding and code-editing tools. Provider network management and credentialing. Fraud detection and SIU processes. Interpersonal & Leadership: Excellent written and verbal communication skills. Ability to build relationships across organizational levels. Strong listening and feedback skills. Proven ability to lead teams, set expectations, and drive accountability. Ethical decision-making and advocacy for team members. Technical Knowledge: Familiarity with security standards (HiTrust, SOC2, HIPAA). Ability to develop expertise in proprietary solutions within 6 months. Education & Experience Bachelor’s degree or Associate degree with
10+ years of medical coding experience . Certification in medical coding and/or fraud investigations preferred.
Remote Employment Type:
Full-Time
Hours of Operation:
Flexible scheduling required to support global operations. Employees may need to attend pre-scheduled meetings and collaborate with international partners outside normal work hours, including occasional weekends.
About the Role We are seeking a
Senior Medical Coder
to serve as the company’s subject matter expert on medical coding and code-edit content. This role ensures accurate and timely implementation of diagnosis, procedure, and episode-of-care codes to maintain compliance and optimize reimbursement integrity. Responsibilities include staff management, quality assurance, compliance monitoring, and collaboration across teams to enhance payment accuracy and revenue optimization.
Responsibilities Act as the company expert on billing codes and code-edit content, updates, and applications. Analyze, validate, and apply coding guidelines to product solutions. Stay current with CMS coding guidelines for inpatient and outpatient services. Validate CMS-related code edits within proprietary solutions. Develop code-editing strategies using advanced AI technology in collaboration with technical teams. Review and analyze patient medical records to accurately assign ICD-10-CM and ICD-10-PCS codes. Ensure accurate code assignment for diagnoses, procedures, and modifiers. Group diagnoses into MS-DRG and apply POA indicators for inpatient encounters. Understand and apply code assignments that may trigger Patient Safety Indicators (PSI). Maintain HIPAA compliance and adhere to CMS and OIG regulations. Ensure compliance with federal, state, and local laws, as well as company policies and ethical standards.
Required Skills and Knowledge Industry Expertise: Strong understanding of healthcare or insurance industry processes, including: HIPAA compliance and healthcare data protection. Claims adjudication, EMR/EHR workflows. Payment integrity and claims processing (835/837 formats). Medical coding and code-editing tools. Provider network management and credentialing. Fraud detection and SIU processes. Interpersonal & Leadership: Excellent written and verbal communication skills. Ability to build relationships across organizational levels. Strong listening and feedback skills. Proven ability to lead teams, set expectations, and drive accountability. Ethical decision-making and advocacy for team members. Technical Knowledge: Familiarity with security standards (HiTrust, SOC2, HIPAA). Ability to develop expertise in proprietary solutions within 6 months. Education & Experience Bachelor’s degree or Associate degree with
10+ years of medical coding experience . Certification in medical coding and/or fraud investigations preferred.