Medical Coding Specialist - I

Ovii's Interpretation of the Role

The Medical Coding Specialist reviews front‑end claims, assigns accurate ICD‑10‑CM and CPT codes, and ensures compliance with payer and HIPAA regulations. The role operates remotely within the United States and requires a current AAPC or AHIMA certification with at least three years of coding experience.

Role Snapshot

• Assign ICD‑10‑CM and CPT codes with modifiers
• Maintain ≥90% coding accuracy
• Resolve front‑end claim holds
• Collaborate with revenue‑cycle partners
• Ensure HIPAA‑compliant documentation
• Complete required CEU credits

Must-Have Requirements

• Current AAPC or AHIMA certification (minimum 3 years)
• Strong working knowledge of CPT and ICD‑10‑CM coding
• Medical terminology, anatomy and physiology knowledge
• Understanding of state and federal Medicare reimbursement guidelines
• Proficiency with Microsoft Office Suite (Word, Excel, Outlook, Teams)
• Ability to read, interpret, and apply policies, procedures, laws, and regulations
• Minimum of 3+ years professional coding experience
• Prior experience in a medical billing environment with HIPAA compliance
• Medical coding
• Medical billing
• HIPAA compliance
• AAPC Certification
• AHIMA Certification
• Must hold a current AAPC or AHIMA certification
• Must have at least 3 years of professional coding experience
• Remote work limited to United States

Work Setup

• Location: United States
• Work mode: REMOTE
• Remote scope: COUNTRY_RESTRICTED
• Remote countries: United States
• Employment type: Full-Time

Eligibility Gates

• Work authorization: Must be authorized to work in United States
• Visa sponsorship: no

Not Specified in JD

• Visa sponsorship

What You'll Likely Work On

• Assign appropriate ICD‑10‑CM and CPT codes with modifiers for professional‑fee services.
• Review medical records to ensure coding meets local and national medical‑necessity guidelines.
• Maintain at least 90% coding accuracy while handling an average of 10 front‑end holds per hour.
• Collaborate with revenue‑cycle partners and the Coding Team Lead to prevent claim rejections and improve clean‑claim rates.
• Stay current on payer policies, Medicare regulations, and HIPAA requirements.
• Participate in department, one‑on‑one, and mentorship meetings with the Coding Team Lead.
• Complete all required continuing‑education units (CEUs) and other assigned duties.

Good Fit If You Have

• Detail‑oriented with strong analytical abilities.
• Excellent written and verbal communication with clinicians and staff.
• Able to work independently in a fast‑paced remote environment.
• Familiarity with medical billing workflows and HIPAA compliance.