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Evaluation/Management Certified Coder | Usa

3 years
Not Disclosed
10 Nov. 26, 2025
Job Description
Job Type: Full Time Education: B.Sc./ M.Sc./ M.Pharm/ B.Pharm/ Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Evaluation and Management (E/M) Certified Coder – USA

Location: United States
Category: Medical Coding | Revenue Cycle
Job Type: Full-Time

About the Role

We are seeking an experienced Evaluation and Management (E/M) Certified Coder to support end-to-end Revenue Cycle Performance and ensure accuracy across coding, documentation, and compliance. This role requires strong analytical capability, expert knowledge of coding guidelines, and the ability to collaborate closely with clients, providers, and internal teams. The position plays a key part in accurate coding of visits and surgeries, denial management, and ongoing provider education.


Key Responsibilities

  • Perform detailed medical record reviews to accurately assign CPT and ICD codes for Evaluation and Management services, procedures, and surgeries.

  • Provide training to providers and coding teams on charge capture workflows and platform usage.

  • Work closely with the Education Supervisor to support system updates, training programs, and ongoing skill development.

  • Assist in developing ICD-10-CM, CPT/HCPCS coding rules, pick lists, and internal documentation.

  • Deliver ongoing education on coding, documentation standards, regulatory compliance, and billing processes.

  • Conduct concurrent coding reviews for newly hired providers and coders.

  • Analyze coded data to ensure documentation accuracy and identify areas for improvement.

  • Provide corrective training when documentation does not meet quality or compliance standards.

  • Educate providers on CMS documentation requirements to support appropriate billing.

  • Review system upgrades, revise departmental documentation, and report workflow-related issues.

  • Stay updated on current coding guidelines and communicate changes promptly to stakeholders.

  • Work with management to assess denials and develop education to reduce future rejections related to medical necessity or coding errors.

  • Apply Medicare billing rules, including LCD/NCD/CCI guidelines.

  • Handle patient information in accordance with HIPAA standards.

  • Support additional Revenue Cycle or account management tasks as assigned.


Required Qualifications

  • Active CPC Certification from AAPC or AHIMA (Required).

  • Minimum Experience:

    • 3 years of specialty-specific medical coding experience (E/M experience required).

    • Experience in Revenue Cycle Management (RCM).

    • Experience in denial management and appeals (preferred).

  • Strong knowledge of clinical workflows and documentation requirements.

  • Expertise in Microsoft Office applications, including Word and Excel.

  • Ability to meet production-level coding standards.

  • Training and education experience is an advantage.

  • Strong understanding of CCI edits.

  • Advanced communication skills, both written and verbal.

  • Ability to successfully pass a medical coding assessment.

  • COSP certification preferred.


Skills and Competencies

  • Advanced proficiency in Excel, Word, and PowerPoint.

  • Attention to detail with strong analytical and documentation skills.

  • Ability to manage complex workflows and resolve coding-related inquiries.

  • Strong understanding of Medicare reimbursement and compliance guidelines.

  • Capability to work independently while supporting team objectives.


Experience Required

  • Minimum 3 years of specialty-specific coding experience.

  • Experience in E/M coding, RCM, clinical documentation, CCI edits, and denial management.

  • Prior training or educational experience is preferred.