Are you a Certified Professional Coder (CPC's) looking to supplement your income in a flexible, remote, nonclinical setting?
Then let me introduce you to ExamWorks medical peer review services!
We are seeking experienced Certified Professional Coders (CPCs) to perform remote medical coding reviews in support of Federal Independent Dispute Resolution (IDR) cases under the No Surprises Act.
This opportunity is ideal for experienced medical coders who are comfortable independently reviewing complex billing and coding documentation and providing detailed, code-level analysis within established turnaround times.
What You’ll Do
As a Medical Coding Reviewer, you will review documentation submitted by both parties involved in Federal IDR payment disputes. Your analysis will help inform the Independent Dispute Resolution Entity’s (IDRE) payment determination.
Responsibilities include:
Review itemized bills, coding documentation, and payment remittance submitted by disputing parties
Assess coding accuracy and supporting documentation
Review DRG and APC assignments
Evaluate modifier usage
Assess the validity of the Qualifying Payment Amount (QPA)
Identify coding discrepancies or other relevant billing issues
Provide clear, code-level analysis to support the IDRE’s payment determination
Complete assigned reviews within required turnaround times
Requirements – What We’re Looking For
Active Certified Professional Coder (CPC) credential through AAPC required
Minimum of 3 years of coding and/or claims experience
CCS, COC, CRC, or other relevant coding credentials are a plus
Experience with out-of-network billing, payment adjudication, or revenue cycle preferred
Strong knowledge of medical coding, billing practices, and claims documentation
Ability to work independently and meet firm deadlines
Ability to maintain neutrality and provide objective analysis
No conflicts of interest with applicable providers, healthcare facilities, or payers, as required under Federal IDR requirements