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Coder - Medical Review (Remote)
About the Job
At IntegrityM, we offer a culture of opportunity, recognition, and collaboration. We thrive off of these fundamental elements that make IntegrityM a great place to work. We offer the flexibility our employees need to challenge themselves and focus on advancing their professional development and careers. Large company perks. Small company feel.
http://www.integritym.com
Job Title: Coder - Medical Review
Location: Remote
Employment Type: Full-Time, Part-Time, PRN
Reports To: Team Lead or Project Manager
Position Overview
The Coder assigns accurate, compliant ICD-10-CM, CPT, HCPCS, and ICD-10-PCS codes across inpatient, outpatient, and physician settings. This role supports utilization review, coding validation, and testing, and quality assurance. Works with project teams to maintain coding accuracy, manage work queues, and ensure the integrity of medical review and policy enforcement.
Key Responsibilities
- Apply expertise in ICD-10, CPT, HCPCS, and ICD-10-PCS coding across inpatient, outpatient, professional, and facility settings.
- Review medical documentation to ensure accurate, compliant coding in accordance with organizational, payer, and regulatory requirements.
- Collaborate with data scientists, clinicians, and policy experts to provide coding input for AI/ML model development and improvement.
- Support quality assurance through coding audits, peer reviews, utilization reviews, and clinical documentation improvement.
- Maintain confidentiality and comply with all privacy, security, and training requirements.
- Participate in team meetings, training, and continuing education to stay current with industry updates.
- Achieve and maintain quality, accuracy, and productivity metrics while exercising sound judgment in applying company policies.
Qualifications
- Minimum of one (1) year of professional (non-internship) experience in medical coding for general acute care hospital (inpatient and outpatient) and multi-specialty physician settings
- Certified/credentialed through an organization such as AHIMA or AAPC (e.g., RHIT, CCS, CPC, CCA or other applicable certification) required
- Proficient in applying ICD-10-CM Coding Guidelines and interpreting Official Coding Clinics
- Familiarity with CPT, HCPCS, and ICD-10-PCS coding systems
- Strong attention to detail and ability to meet productivity and quality benchmarks
- Ability to work independently and as part of a distributed team in a remote setting
- Effective communication and collaboration skills
- Experience with managed care or commercial insurance
- Experience or exposure to Medicare and/or Medicaid
About the Company
Overview
Integrity Management Services, Inc. (IntegrityM) is a Certified Women-Owned Small Business, CMMI Level 3 appraised, ISO 9001:2015 certified, and FISMA compliant organization.
IntegrityM was created to support the program integrity efforts of federal and state government programs, as well as private sector organizations.
IntegrityM provides experience and expertise to government programs and private businesses supporting government programs. Results are achieved through analysis and support services such as, statistical and data analysis, compliance audit, investigation, medical review, and software solutions.
At IntegrityM, we specialize in complex data and statistical analysis and auditing. Our SMEs, data analysts, and statisticians convert theory to workable, informative analysis. Our audit team has decades of experience in the design and conduct of complex audits, compliance reviews and investigations. We have a highly effective IT staff with experience and skill in creating large databases, building support systems for our auditors and investigators and establishing secure communications networks with our clients. We have written, established quality assurance procedures in place to ensure we produce quality products for our customers.
We are skilled and proven at problem-solving and vigorous in seeking innovative ways to assist our clients.
Skills
Key Details
- Experience:
- Entry Level
- Job Domain/Function:
- Business Consulting and Services
- Job Type:
- Remote
- Employment Type:
- Part Time
- Number of position(s):
- 25
- Educational qualifications:
- Students & Fresh Graduates