Medical Coder II/III

Medical Coder II/III CodaMetrix is revolutionizing Revenue Cycle Management with its AI-powered autonomous coding solution, a multi-specialty AI-platform that translates clinical information into accurate sets of medical codes. CodaMetrix’s autonomous coding drives efficiency under fee-for-service and value-based care models and supports improved patient care. We are passionate about getting physicians and healthcare providers away from the keyboard and back to clinical care. OVERVIEW Reporting to the Manager, Medical Coding & Audit, as a Medical Coder II or III, this role will be a key member of the team responsible for ensuring that CodaMetrix meets—and exceeds—our customers’ coding quality expectations. The Medical Coder II or III will be responsible for leveraging their strong background in coding, billing, and auditing across service lines to review, analyze, and enhance coding processes, both internally and externally. They will play a pivotal role in improving the quality and efficiency of coding operations by collaborating closely with cross-functional teams, including Machine Learning, Product, and Customer Implementations. They will also review and validate model-generated codes, annotate and label data to support model training, identify patterns in coding errors, and provide clear explanations and insights to both internal teams and external clients. This role requires a proven ability to communicate highly complex coding issues and solutions to a wide range of stakeholders, alongside an unwavering commitment to continuous learning, quality, and innovation in medical coding practices. Key Responsibilities 1. Coding & Documentation review - Serve as the internal and external Subject Matter Expert (SME) on medical coding and billing across assigned service lines. - Review and validate model-generated CPT, ICD-10-CM, HCPCS, and E&M codes - Perform high-quality coding and auditing on inpatient, outpatient, ED, or pro-fee encounters (depending on specialty) - Ensure documentation fully supports coding decisions in alignment with AMA, CMS, and payer guidelines - Identify missed codes, incorrect E/M leveling, modifier errors, and insufficient documentation 2. Customer & Workflow Analysis - Analyze and document customers’ coding practices and workflows to facilitate optimal use of the CodaMetrix product. - Identify and share Codametrix’s best practices for coding automation and workflow improvements with the customer. - Present audit results to customer stakeholders and facilitate sign-off for go-live milestones. 3. Coding Quality Management - Assist manager with Coding Quality Assessment (CQA) projects, including work assignments, training, and quality assurance for offshore coding staff. - Leverage CodaMetrix coding standards to drive world-class coding quality and consistency. 4. Collaboration & Knowledge Sharing - Work with product and engineering to provide precise, consistent feedback on model training and data annotation - Continuously improve evaluation and training materials on coding and billing to colleagues and customers. - Share knowledge throughout CodaMetrix to build internal competencies and champion continuous improvement initiatives. - Provide expert guidance on coding and billing questions to support Machine Learning and Product teams. 5. Compliance & Professional Development - Proactively stay up to date with changes in medical coding and billing by maintaining relevant certifications and participating in ongoing education. - Uphold all legal and ethical requirements, ensuring accuracy, confidentiality, and compliance in all coding and audit activities. 6. Customer Communication - Help explain model decisions, error analyses, and coding rationales to clients - Support customer success and implementation teams in understanding coding outputs - Prepare clear written summaries of coding patterns, documentation issues, or model behavior - Represent coding accuracy and detail ... (truncated, view full listing at source)