Certified Medical Coder

Certified Medical Coder/Medical Record Audit Specialist<\/span><\/span><\/b>

We are seeking a detail\-oriented Certified Medical Coder / Medical Record Audit Specialist<\/b> to support coding accuracy, medical record review, and billing compliance activities for Indiana Medicaid programs. This role is responsible for reviewing medical records and claims\-related documentation for coding accuracy, identifying billing and compliance issues, preparing audit documentation and reports, and supporting appeals activities. The ideal candidate brings strong coding knowledge, regulatory awareness, and analytical and writing skills. This is a remote position with occasional travel required within Indiana.
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Key Responsibilities<\/span><\/span><\/b>
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\u2022 Review medical records and related documentation to assess coding accuracy and compliance with Indiana Health Coverage Programs, CMS, AMA, and other applicable standards and regulations.
\u2022 Conduct coding and documentation reviews independently and provide preliminary findings to the Lead Reviewer.
\u2022 Identify potential coding discrepancies, documentation deficiencies, and billing compliance issues.
\u2022 Maintain detailed workpapers documenting procedures performed, records reviewed, findings identified, and conclusions reached.
\u2022 Assist with audit responses and appeals as needed.
\u2022 Ensure all work aligns with state, federal, and national coding and reimbursement guidelines.
\u2022 Stay current on CPT, HCPCS, ICD\-10\-CM, and Medicaid coding guidelines, policies, and regulatory updates.
\u2022 Research Indiana Medicaid rules and maintain internal repositories of bulletins, policies, and procedures.
\u2022 Adapt quickly to changing priorities, policies, regulatory updates, and review requirements while maintaining accuracy and meeting deadlines.<\/span><\/span>

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Requirements<\/h3>

Qualifications<\/span><\/span><\/b>
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\u2022 Coding certification such as CCS, CPC, or CPMA required.
\u2022 At least 1 year of medical coding, claims review, billing compliance, or related healthcare reimbursement experience.
\u2022 Familiarity with Indiana Medicaid policies, payer guidelines, and documentation requirements preferred.
\u2022 Candidate located in or near the Indianapolis area preferred.
\u2022 Proficiency in Microsoft Excel, Word, and Outlook.
\u2022 Strong analytical, critical thinking, problem\-solving, and technical writing skills.
\u2022 Ability to work independently and collaboratively in a fast\-paced environment.
\u2022 Experience working with healthcare providers strongly preferred.
\u2022 Knowledge of healthcare claims data and fraud, waste, and abuse preferred.<\/span><\/span><\/p>\n

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