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CodaMetrix · 1 month ago

Medical Coder II/III

United States

Full-time

Remote

Mid, Senior Level

$75K/yr - $115K/yr

3+ years exp

CodaMetrix is revolutionizing Revenue Cycle Management with its AI-powered autonomous coding solution. The Medical Coder II/III will play a key role in ensuring coding quality, collaborating with various teams to enhance coding processes and improve efficiency in operations.

Artificial Intelligence (AI)Electronic Health Record (EHR)Health CareMedical

Responsibilities

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

Represent coding accuracy and detail in client conversations, as needed

Collaborate with cross-functional teams—such as Data Science, Product, and Customer Success—to address client needs and optimize results

Qualification

AHIMAAAPC credentialCPT codingICD-10-CM codingHCPCS codingE/M guidelinesCoding experienceAuditing experienceCustomer service skillsCommunication skillsCritical thinkingTeam-oriented approach

Required

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

Preferred

Experience in Radiology or Pathology

Prior experience with ML/AI workflows

Experience working with JIRA or other project management/ task management tools

Familiarity with autonomous coding platforms

Experience serving large health systems from a services or technology perspective

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