Medical Coder II

Job Title: Medical Coder II
Location: Orlando, FL - 100% Remote (Must reside in one of the following states: FL, GA, ID, IA, KY, MI, NE, NM, NY [outside NYC], OH, TX, UT, WA [outside Seattle], WI, AZ)
Duration: 6 Months+ Contract (with possible extension)
 
Schedule: Monday to Friday, 8:00 AM – 4:30 PM CST
 
Position Overview:
The Medical Coder II plays a critical role in accurate risk adjustment coding, chart review, and provider education. This position is responsible for interpreting medical records and translating clinical documentation into standardized codes while ensuring compliance with CMS guidelines and payer requirements. This role involves working cross-functionally to support revenue integrity and claims processing accuracy.
 
Key Responsibilities:

• Perform detailed chart reviews and diagnosis code abstraction (ICD-10-CM, CPT, HCPCS).
• Ensure compliance with CMS and Risk Adjustment coding standards.
• Provide coding education and training to providers and internal stakeholders.
• Conduct audits to validate accurate coding and identify documentation improvement opportunities.
• Develop and distribute educational materials (e.g., newsletters, training guides).
• Support provider offices with coding process improvements and best practices.
• Collaborate with teams across Claims, Revenue, Informatics, and Medical Affairs.
• Participate in CMS Data Validation (RADV) and quality improvement initiatives.
• Maintain and update HIPAA-compliant code sets, policy documents, and internal systems.
• Track and analyze utilization data and support audit activities.
• Serve as a subject matter expert on coding policies and code sets for internal teams and external partners.

 
Required Qualifications:

• Education:
  • Associate’s Degree or equivalent work experience required
  • Bachelor’s Degree preferred
• Certifications (Must have one active & unrestricted):
  • CPC (Certified Professional Coder) – Required
  • Other accepted: CIC, CCS, RHIT, RHIA
• Experience:
  • 2–4 years of professional or hospital coding experience
  • 2+ years of medical record chart review
  • Knowledge of insurance claims processing
  • Prior experience working with CMS Risk Adjustment, HCC coding preferred

 
Skills & Competencies:

• Proficient in Microsoft Office Suite (especially Excel)
• Solid understanding of ICD-10, CPT, HCPCS coding
• Ability to work independently in a remote setting
• Strong communication skills – verbal and written
• Excellent organizational and time management abilities
• High attention to detail and quality standards
• Ability to maintain HIPAA compliance and data confidentiality
• Strong collaboration and cross-functional team coordination skills

 
Preferred Experience:

• Experience working in payer or provider organizations
• Exposure to Medicare Advantage or Medicaid risk adjustment programs
• Familiarity with clinical informatics systems and audit tools