[Hiring] Medical Reviewer, Coder @J29, Inc
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Role Description
This position is contingent upon the successful award of the associated contract. Employment is not guaranteed until the contract is awarded, and the position is officially activated. Job responsibilities and requirements are subject to change.
• Perform both automated and complex reviews of Medicare Fee-for-Service (FFS) claims—including Part A/B, DMEPOS, and Home Health/Hospice
• Assess overpayments, underpayments, and proper payments as determined by Recovery Audit Contractors (RACs)
• Apply Medicare policies and guidelines, ensuring claims are evaluated according to National and Local Coverage Determinations and CMS rules
• Document clear, accurate findings for each claim
• Participate in dispute resolution by re-examining claims and providing supporting documentation
• Support quality assurance through audits and ongoing training
• Maintain compliance with CMS security and privacy standards
• Collaborate closely with key personnel to ensure consistency, accuracy, and continuous process improvement in all review activities
Qualifications
• 5+ years of direct medical coding or medical billing experience, specifically in a healthcare environment
• 3+ years working in a productivity-based claims or case working environment, out of a queued case management system
• 3+ years working remotely with various technology systems
• 3+ years of Medicare Fee For Service (FFS) experience in a medical coding role or program
• Experience with low-code, no-code case management systems as an end-user is preferred but not required
Education/Certification
• Certified from an accredited association such as the American Association of Professional Coders (AAPC) or American Health Information Management Association (AHIMA)
• May also be Registered Health Information Administrators (RHIA) and Registered Health Information Technicians (RHIT); credentialed by AHIMA in their field of health information
Location
• Remote (United States)
Salary
• $45,000-55,000
Company Description
• J29, Inc. is committed to hiring and retaining a diverse workforce
• Proud to be an Equal Opportunity/Affirmative Action Employer
• Making decisions without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class
• Proud Veteran friendly employer
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Role Description
This position is contingent upon the successful award of the associated contract. Employment is not guaranteed until the contract is awarded, and the position is officially activated. Job responsibilities and requirements are subject to change.
• Perform both automated and complex reviews of Medicare Fee-for-Service (FFS) claims—including Part A/B, DMEPOS, and Home Health/Hospice
• Assess overpayments, underpayments, and proper payments as determined by Recovery Audit Contractors (RACs)
• Apply Medicare policies and guidelines, ensuring claims are evaluated according to National and Local Coverage Determinations and CMS rules
• Document clear, accurate findings for each claim
• Participate in dispute resolution by re-examining claims and providing supporting documentation
• Support quality assurance through audits and ongoing training
• Maintain compliance with CMS security and privacy standards
• Collaborate closely with key personnel to ensure consistency, accuracy, and continuous process improvement in all review activities
Qualifications
• 5+ years of direct medical coding or medical billing experience, specifically in a healthcare environment
• 3+ years working in a productivity-based claims or case working environment, out of a queued case management system
• 3+ years working remotely with various technology systems
• 3+ years of Medicare Fee For Service (FFS) experience in a medical coding role or program
• Experience with low-code, no-code case management systems as an end-user is preferred but not required
Education/Certification
• Certified from an accredited association such as the American Association of Professional Coders (AAPC) or American Health Information Management Association (AHIMA)
• May also be Registered Health Information Administrators (RHIA) and Registered Health Information Technicians (RHIT); credentialed by AHIMA in their field of health information
Location
• Remote (United States)
Salary
• $45,000-55,000
Company Description
• J29, Inc. is committed to hiring and retaining a diverse workforce
• Proud to be an Equal Opportunity/Affirmative Action Employer
• Making decisions without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class
• Proud Veteran friendly employer
Apply tot his job
Apply To this Job