[Hiring] Certified Medical Coder @MMC Group

Role Description

Put Your Medical Coding Expertise to Work From Home!

Are you an experienced Certified Medical Coder with a strong background in reimbursement reviews, revenue cycle management, and payment analysis? We are seeking a detail-oriented professional to join our team in a remote, temp to hire opportunity where you'll play a critical role in ensuring accurate reimbursement decisions and supporting healthcare payment integrity.

If you enjoy solving complex reimbursement challenges, analyzing medical claims, and making data-driven decisions, we'd love to hear from you.

As a Certified Medical Coder, you will perform retrospective payment reimbursement reviews while ensuring compliance with coding guidelines, payer policies, and reimbursement regulations.

• Review complex medical claims and reimbursement determinations
• Analyze payment discrepancies, denials, recoupments, and claim adjustments
• Interpret Explanations of Benefits (EOBs) to determine appropriate reimbursement
• Apply CPT, ICD-10-CM, HCPCS, and modifier guidelines accurately
• Evaluate payer policies, regulatory requirements, and contractual obligations
• Research and resolve reimbursement issues through critical analysis
• Prepare clear, professional, and well-supported payment determination letters
• Identify reimbursement trends and revenue recovery opportunities
• Ensure compliance with coding standards and healthcare regulations
• Collaborate with internal teams to resolve complex reimbursement scenarios
• Manage multiple priorities while maintaining exceptional accuracy and meeting deadlines

Qualifications

• 3 to 5 years of medical coding and reimbursement review experience
• Current Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification through AAPC or AHIMA
• Strong knowledge of ICD-10-CM, CPT, HCPCS, CPT modifiers, and reimbursement methodology
• Experience interpreting Explanations of Benefits (EOBs), including payment corrections, recoupments, claim adjustments, and underpayments
• Broad knowledge of CPT coding across multiple medical specialties
• Strong understanding of healthcare reimbursement and payer guidelines
• Exceptional analytical, critical thinking, and problem-solving skills
• Excellent written communication skills with the ability to prepare formal payment determination letters
• Ability to manage multiple priorities in a fast-paced, deadline-driven environment
• High level of accuracy and attention to detail

Requirements

• Experience with Revenue Cycle Management (RCM), including charge capture, claims submission, payment posting, denial management, appeals, accounts receivable, contract compliance, underpayment identification, and revenue recovery analysis
• Knowledge of the No Surprises Act and its impact on reimbursement and billing practices is highly preferred
• High School Diploma or GED required
• Associate's degree from an accredited college or university preferred

Benefits

• Fully remote position
• Equipment provided
• Monday through Friday schedule with evenings and weekends off
• Temp to hire opportunity with long-term career potential
• Join a collaborative team focused on payment integrity and healthcare compliance
• Work on challenging, meaningful reimbursement reviews that directly impact healthcare outcomes