Professional, Coding

Medical Coder – E/M (CPC/CCS)Job Title: Medical Coder – E/M, Preventive Services & Minor ProceduresCertification Required: Certified Professional Coder (CPC, AAPC) or Certified Coding Specialist (CCS, AHIMA)Work Arrangement: RemoteEmployment Type: Full-TimeExperience Level: Mid-Level (4-6 years)Department: Coding / Revenue Cycle ManagementReports To: Coding Manager / Coding Supervisor
Job Summary

Advantum Health is seeking an experienced, certified Medical Coder (CPC or CCS) to join our remote coding team. This role is responsible for accurately reviewing clinical documentation and assigning codes for evaluation and management (E/M) services, preventive/wellness visits, and minor in-office procedures across multiple specialties. The ideal candidate has 2–4 years of hands-on coding experience, a strong working knowledge of CPT, ICD-10-CM, and HCPCS Level II guidelines, hands-on Epic EHR experience, and a track record of accurate, compliant, audit-ready coding that supports clean claims and timely reimbursement.Key Responsibilities

Coding & Chart Review

• Review clinical documentation and assign accurate CPT, ICD-10-CM, and HCPCS Level II codes for E/M visits (new and established patient, all levels), annual wellness/preventive visits, and minor in-office procedures (e.g., injections and infusions, wound care, skin lesion removals, incision and drainage, laceration repair).
• Apply correct E/M leveling based on current CMS/AMA guidelines (medical decision making- and time-based selection), ensuring documentation supports the code(s) billed.
• Determine appropriate use of modifiers (e.g., 24, 25, 57, 59, XE/XP/XS/XU) and apply NCCI/MUE edits correctly to avoid unbundling, upcoding, or downcoding.
• Code across multiple specialties and provider types as assigned (e.g., primary care, internal medicine, family medicine, multi-specialty clinics).
• Responsible for accurate, compliant coding of HCC (Hierarchical Condition Category) encounters, ensuring chronic and comorbid conditions are captured to the highest level of specificity supported by clinical documentation. Reviews provider documentation for completeness under MEAT (Monitor, Evaluate, Assess/Address, Treat) criteria.
• Works to close risk adjustment gaps identified through claims, EMR, or payer suspecting reports. Maintains current knowledge of CMS-HCC and/or HHS-HCC risk adjustment models, ICD-10-CM coding guidelines, and payer-specific RADV audit requirements, and supports internal coding audits to minimize compliance risk.
Quality, Compliance & Documentation Integrity

• Identify documentation gaps, ambiguities, or discrepancies and generate compliant, non-leading provider queries for clarification.
• Maintain coding accuracy at or above department quality benchmarks (e.g., 95%+ accuracy) and meet established productivity/turnaround-time standards.
• Participate in internal and external coding audits; research and resolve audit findings, and implement corrective action or additional training as needed.
• Maintain strict adherence to HIPAA, payer contractual requirements, and all applicable federal/state coding compliance standards.
Denials, Appeals & Cross-Functional Support

• Collaborate with billing, compliance, and clinical staff to research and resolve coding-related claim denials, rejections, and payer requests for additional documentation.
• Support appeals for coding-related denials with clear, guideline-based rationale.
• Respond to ad hoc coding questions from providers, billing staff, and management.
Continuing Education

• Stay current on annual CPT/ICD-10-CM/HCPCS updates, payer-specific coding policies, LCD/NCD guidance, and CMS/AAPC/AHIMA bulletins.
• Maintain certification through required continuing education units (CEUs) and complete AdvantumHealth's ongoing training requirements.
Required Qualifications

• Active coding certification: Certified Professional Coder (CPC) through AAPC, or Certified Coding Specialist (CCS) through AHIMA — required, non-negotiable.
• 4-6 years of professional experience coding E/M services, preventive/wellness visits, and minor procedures in a physician office, outpatient, or multi-specialty setting.
• High school diploma or equivalent required; associate degree or coursework in health information management, medical billing/coding, or a related field preferred.
• Strong working knowledge of CPT, ICD-10-CM, and HCPCS Level II coding systems and official coding guidelines.
• Demonstrated understanding of E/M leveling (MDM- and time-based), modifier usage, and NCCI/MUE/payer-specific edits.
• Hands-on experience working within the Epic EHR system (chart review, coding workqueues, and/or coding-related modules).
• Proficiency with encoder or coding software (e.g., 3M, EncoderPro, or similar) in addition to Epic.
• Strong attention to detail, analytical and critical-thinking skills, and the ability to work independently and meet deadlines in a remote setting.
• Effective written communication skills for provider queries and denial/appeal documentation.
• Reliable high-speed internet and a private, secure, HIPAA-compliant home workspace.
• Ability to pass a background check and any required client/payer credentialing screening.
Preferred Qualifications

• Both CPC and CCS credentials, or an additional specialty certification (e.g., CEMC, COC, CRC, CFPC) a plus.
• 3+ years of experience specifically coding for primary care, internal medicine, family medicine, or multi-specialty practices.
• Familiarity with payer-specific policies (Medicare, Medicaid, major commercial payers) and prior experience with formal quality audits or peer review.
• Experience supporting provider education, coding compliance initiatives, or new coder training/mentoring.
• Experience working within a multi-client or outsourced coding/RCM environment.
Key Competencies for Success

• Accuracy and consistency: applies coding guidelines the same way, visit after visit, without shortcuts.
• Independent judgment: recognizes when documentation does and does not support a code, and escalates appropriately.
• Adaptability: comfortable moving across specialties, payers, and periodic guideline updates.
• Professional communication: query language is clear, compliant, and non-leading.
• Self-management: meets productivity and quality targets with minimal oversight in a remote setting.
Work Environment & Schedule

This is a fully remote position. Candidates must be able to maintain productivity and accuracy standards independently, participate in scheduled virtual team meetings and training, and safeguard protected health information (PHI) in accordance with HIPAA requirements in a home office setting. Standard schedule is Monday–Friday during core business hours [confirm hours/time zone]; occasional flexibility may be required to meet client turnaround-time commitments.Equipment: Advantum Health provides dual monitors, encoder resources, VPN/security software. Candidate is responsible for providing a private workspace and reliable high-speed internet meeting company security requirements.Compensation & Benefits

Compensation is competitive and commensurate with experience and certification(s) held. Equal Employment Opportunity

AdvantumHealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by applicable law.

Department: CODINGOP
Experience: 4-6
Posted: 2026-09-11T09:39:53.107Z