State Licensed Senior Medical Coder

A company is looking for a Senior Medical Coding Reviewer. Key Responsibilities Minimize fraud, waste, and abuse by performing medical claim reviews for compliance with coding guidelines Provide coding/clinical decisions on claims, adjustments, and appeals according to coding guidelines and payment policies Lead a team in defending payment decisions during state fair hearings and maintain review guidelines for medical coding Required Qualifications Associate's Degree in Nursing or a related field required 4+ years of Medical Coding Experience required Licensure as LPN or RN, or certifications such as CPC, CCS, RHIT, RHIA, or CPMA required Experience in provider education and medical record auditing preferred Experience in a managed care organization preferred

Jun 10, 2025 - 22:10

A company is looking for a Senior Medical Coding Reviewer. Key Responsibilities Minimize fraud, waste, and abuse by performing medical claim reviews for compliance with coding guidelines Provide coding/clinical decisions on claims, adjustments, and appeals according to coding guidelines and payment policies Lead a team in defending payment decisions during state fair hearings and maintain review guidelines for medical coding Required Qualifications Associate's Degree in Nursing or a related field required 4+ years of Medical Coding Experience required Licensure as LPN or RN, or certifications such as CPC, CCS, RHIT, RHIA, or CPMA required Experience in provider education and medical record auditing preferred Experience in a managed care organization preferred