Certified Professional Coder (CPC)

Great Employment opportunity for a Certified Professional Coder or Professional Specialist

Location: East Hartford, CT; Hybrid

Interview: Virtual, 2 rounds. Coding test

Hourly pay rate up to $27/hour

We are seeking a highly skilled and detail-oriented Certified Professional Coder to join our healthcare coding team. In this vital role, you will be responsible for accurately translating medical diagnoses, procedures, and services into standardized codes used for billing, reimbursement, and statistical purposes. The ideal candidate will possess comprehensive knowledge of medical coding guidelines, anatomy, physiology, and medical terminology, ensuring compliance with industry standards and payer requirements. This position offers an excellent opportunity to contribute to efficient revenue cycle management while supporting high-quality patient care documentation.

The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

• Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager
• Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans
• Appropriately document work and final conclusions in designated computer program
• Additional duties as assigned

KNOWLEDGE & SKILLS:

• Thorough knowledge of ICD Diagnoses and Procedure Codes, and CP.T., as well as an understanding of medical terminology
• Knowledge of applicable fee schedule and or applicable U&C Guidelines
• Proficient in Microsoft Office applications
• Comfortable using 3 monitors
• Technical aptitude with the ability to expand knowledge of proprietary systems
• Ability to work independently, follow process guidelines, and meet productivity standards and timelines (must maintain a score of 98% or higher on performance audits)
• Review/research experience
• Attention to Details

EDUCATION & EXPERIENCE:

• Associate’s degree or equivalent experience
• CPC or CPC-A required
• Previous experience in the following areas preferred:
• Medical bill auditing & experienced CPC required
• Surgical coding experience preferred
• Knowledge of workers' compensation claims process preferred
• Prospective, concurrent and retrospective utilization review

If you are committed to precision in medical coding and eager to contribute your expertise within a dynamic healthcare environment, we encourage you to apply today.