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Medical Bill Coder / Bill Reviewer / audits from a Payer side. (Insurance company side)

Work from home Full-time role Hiring

Medical Bill Coder / Bill Reviewer / audits from a Payer side. (Insurance company side) Medical Bill Coder / Bill Reviewer / audits from a Payer side. (Insurance company side) Get AI-powered advice on this job and more exclusive features. Direct message the job poster from Pegasus Knowledge Solutions, Inc. Talent Acquisition Specialist at Pegasus Knowledge Solutions Job Title : Medical Bill Coder Location : Remote Type : Full-time Position Summary We are seeking a detail-oriented and knowledgeable Medical Bill Coder who can review, validate, and apply appropriate coding to medical bills in compliance with state-specific regulations and industry standards. The ideal candidate will ensure billing accuracy, improve claims efficiency, and reduce compliance risk.

Key Responsibilities

  • Review incoming medical bills for completeness and accuracy.
  • Assign proper CPT, ICD-10, and HCPCS codes based on medical records and documentation.
  • Ensure coding aligns with state regulations, payer-specific rules, and MedRisk policies.
  • Identify and correct coding discrepancies, unbundled codes, or documentation gaps.
  • Collaborate with billing, claims, and compliance teams to resolve coding-related issues.
  • Stay updated with coding changes, fee schedules, and relevant state legislation.
  • Support audits and internal reviews as needed.

Qualifications

  • Certification: CPC, CCS, or equivalent required.
  • Minimum 3-5 years of experience in medical coding, preferably in a workers’ compensation or physical medicine environment.
  • Strong understanding of state-specific billing guidelines and medical coding compliance.
  • Proficiency with EHR systems and coding software (e.g., EncoderPro, Availity).
  • High attention to detail, strong analytical skills, and ability to meet deadlines. Preferred Skills
  • Experience working with workers’ compensation claims.
  • Familiarity with NCCI edits and payer-specific rules. Criteria for this role is : Billing coder and reviewers with experience in Workers compensation Who has done Bill coding / review / audits from a Payer side. (Insurance company side) 847-201-6116 Seniority level
  • Seniority level Mid-Senior level Employment type
  • Employment type Full-time Job function
  • Job function Business Development, Information Technology, and Consulting
  • Industries Medical Practices, Hospitals and Health Care, and Health and Human Services Referrals increase your chances of interviewing at Pegasus Knowledge Solutions, Inc. by 2x Get notified about new Medical Coder jobs in United States. United States $60,000.00-$75,000.00 1 week ago In Patient Coder (Remote) | Health Information & Record Management | Full Time Medical Billing & Coding Specialists (Remote – Work From Anywhere) Remote: Full Time Profee General Surgery Coder Medical Coder In Patient Coder (Remote) | Health Information & Record Management | Full Time Medical Coding Specialist - Hospital and Ambulatory Surgery Center Outpatient Coder II, HB Coding, Full-time, Days (Remote - Must reside in IL, IN, IA, or WI - Sign-on bonus eligible) Florida, United States $68,000.00-$78,000.00 2 weeks ago Texas, United States $68,000.00-$78,000.00 2 weeks ago CERTIFIED OUTPATIENT MEDICAL CODER -- FULLY REMOTE (23348) We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. Apply tot his job

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