Certified Medical Coder (Medicare)

Location: Fully remote, Remote, VA, USA

Salary: $58,000–$78,000 per year

Company

hirify.global develops data-centric healthcare solutions that combine technology, clinical expertise, and quality data to improve care outcomes and operational efficiency.

What you will do

• Perform coding-only medical reviews of Medicare Part A/B and DMEPOS claims.
• Apply ICD-10-CM/PCS, CPT/HCPCS, and DRG/APR-DRG coding rules to verify claim accuracy.
• Research NCDs, LCDs, and CMS coding and payment guidance and document coding determinations.
• Identify potential improper payments, coding errors, and documentation patterns indicating fraud, waste, or abuse for referral.
• Maintain claim review records in the case tracking system and support re-reviews and provider education sessions.
• Maintain accuracy standards and complete required ethics, records management, security, and compliance training.

Requirements

• 3+ years of direct experience in medical coding, medical billing, coding quality assurance, or healthcare auditing.
• Active AAPC or AHIMA certification: CPC, CCS, CCS-P, CRC, RHIA, or RHIT.
• Ability to apply and document CMS coverage, coding, and payment rules, including NCDs and LCDs.
• Ability to work independently in a remote, technology-driven, queue-based claims review environment.
• Working knowledge of HIPAA, PHI/PII confidentiality and privacy requirements, and CMS information security requirements.
• Associate’s degree in a related discipline, or equivalent certification and relevant experience.

Nice to have

• 3+ years of Medicare Fee-for-Service claim review experience.
• Experience with queue-based or low-code/no-code case management systems.
• Experience with CMS program integrity, audit, or medical review contracts such as MAC, RAC, UPIC, or SMRC.

Culture & Benefits

• Full-time employment in a remote, technology-driven work environment.
• Work is performed in a climate-controlled setting with extended computer and screen use.
• Reasonable accommodations are available for individuals with disabilities.
• Merit-based equal employment opportunity practices.