Medical Coder II​/III

Medical Coder II/III

Join Coda Metrix as a Medical Coder II or III. This role reports to the Manager, Medical Coding & Audit and is essential to ensuring we meet—and exceed—our customers’ coding quality expectations.

$75,000.00/yr – $/yr (actual pay based on skills and experience)

As a Medical Coder II/III, you will review, analyze, and enhance coding processes both internally and externally. You will collaborate closely with cross‑functional teams—Machine Learning, Product, and Customer Implementations—to improve the quality and efficiency of our coding operations. Your work will include reviewing and validating model‑generated codes, annotating data for model training, identifying coding error patterns, and communicating insights to internal teams and external clients.

• Coding & Documentation Review
  • Serve as the internal and external 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.
  • 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.
• Customer & Workflow Analysis
  • Analyze and document customers’ coding practices and workflows to facilitate optimal use of the Coda Metrix product.
  • Share 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.
• Coding Quality Management
  • Assist manager with Coding Quality Assessment (CQA) projects, including work assignments, training, and quality assurance for offshore coding staff.
  • Leverage Coda Metrix coding standards to drive world‑class coding quality and consistency.
• 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.
  • Share knowledge throughout Coda Metrix to build internal competencies and champion continuous improvement initiatives.
  • Provide expert guidance on coding and billing questions to support Machine Learning and Product teams.
• Compliance & Professional Development
  • 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.
• Customer Communication
  • 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 in client conversations, as needed.
  • Collaborate with cross‑functional teams—such as Data Science, Product, and Customer Success—to address client needs and optimize results.

• Current AHIMA or AAPC coding credential held for 3+ (level II) or 5+ years (level III).
• 3‑5 (level II) or 5+ years (level III) of coding and auditing experience with progressive growth in responsibilities.
• Strong understanding of CPT, ICD‑10‑CM, HCPCS, modifiers, and 2023 E/M guidelines.
• Experience in one of the following specialties: surgical or procedural hospital coding; specifically in Surgery, Endoscopy, Hospitalist, Cardiology, or Emergency coding.
• Demonstrated ability to interpret clinical documentation and identify gaps.
• Excellent communication and customer service skills, capable of engaging executives, directors, data scientists, and other stakeholders.
• Ability to translate complex coding guidelines to non‑clinical team members.
• Strong organizational and detail‑oriented approach with a demonstrated commitment to excellence and precision.
• Critical thinking, intellectual curiosity, and creativity in problem‑solving.
• Ability to thrive under time constraints in a fast‑paced environment.
• Team‑oriented…