Medical Coding Consultant - On-Site - $25 - $33 Hourly Wage
$25.00 - $33.00 per hour
Apply now (opens in a new tab)Medical Coding Consultant - On-Site - $25 - $33 Hourly Wage
L5
$25.00 - $33.00 per hour
Occupations
Health Information Technologists and Medical RegistrarsMedical Records SpecialistsHealth Informatics SpecialistsIndustries
Administrative Management and General Management Consulting ServicesAll Other Miscellaneous Ambulatory Health Care ServicesOther Scientific and Technical Consulting Services- The Independent Medical Coding Consultant will provide subject matter expertise in clinical coding validation, AI-assisted coding optimization through XpertDox, and billing workflow improvement within Athena.
- You will serve as a key liaison between operational billing staff and the coding technology vendor, helping identify opportunities to improve coding accuracy, accelerate claims processing, reduce claim holds and coding-related denials, and strengthen overall revenue cycle performance.
- Key Objectives
- In this role, you will help us:
- Validate corrected medical claims and coding recommendations generated through XpertDox.
- Improve AI-assisted coding accuracy through feedback, testing, and training.
- Build internal billing team expertise in coding validation and claim correction.
- Reduce claim holds, missing slips, and coding-related claim denials.
- Establish standardized coding validation, workflow, and quality assurance processes within Athena.
- Improve billing efficiency and claim throughput while maintaining regulatory and coding compliance.
- Reviewing and validating corrected claims prior to submission.
- Auditing coding recommendations generated by XpertDox AI.Verifying diagnosis, procedure, and modifier selection against provider documentation.
- Identifying coding discrepancies and documentation deficiencies.
- Providing corrective recommendations to billing and clinical teams.
- Conducting random and targeted claim audits to measure coding accuracy and identify trends.
- Key Deliverables:
- Coding validation reports
- Monthly audit findings and trend reportsCoding error tracking log
- Process improvement recommendations 2. XpertDox AI Optimization & Vendor Collaboration Partner with XpertDox implementation and technical teams to continuously improve AI-assisted coding performance.
- Reviewing AI-generated coding output.
- Providing detailed feedback on coding accuracy and missed coding opportunities.
- Identifying patterns contributing to coding errors or claim holds.
- Participating in testing and validation of AI model enhancements.
- Supporting the development and refinement of coding rules, logic, and validation protocols.
- Translating real-world coding expertise into actionable recommendations for technology improvements.
- Key Deliverables:
- AI performance assessment reportsCoding correction and feedback logs
- User acceptance testing documentation
- Recommendations for AI training and performance improvements 3. Billing Team Education & Knowledge Development Help build a stronger, more confident billing team through practical education and ongoing coaching.
- You will:
- Train billing personnel on coding review and validation procedures.
- Educate staff on ICD-10, CPT, HCPCS, modifiers, and documentation requirements.
- Develop job aids, training materials, and coding reference guides.
- Conduct workflow coaching and ongoing competency development sessions.
- Provide case-based learning using real-world claims examples.
- Help establish consistent coding review practices across the team.
- Key Deliverables:
- Training curriculum
- Standard operating procedures (SOPs)
- Billing reference guides
- Monthly training sessions
- Staff competency assessments 4. Athena Workflow Assessment & Optimization Evaluate current revenue cycle workflows and identify opportunities to make billing processes more efficient and effective.
- You will:
- Review existing Athena revenue cycle workflows.
- Analyze the causes of claim holds and work queue backlogs.
- Assess missing slip workflows and charge capture processes.
- Develop standardized claim review and escalation procedures.
- Create work queue management and prioritization processes.
- Recommend automation opportunities and process redesign initiatives.
- Develop practical solutions that improve workflow consistency and claim throughput.
- Key Deliverables:
- Current-state workflow assessment
- Future-state workflow design
- Athena work queue optimization recommendations
- Workflow maps and SOP documentation 5. Claims Hold Reduction Initiative Take a data-driven approach to identifying and reducing preventable claim holds.
- You will:
- Analyze historical claims hold data.
- Categorize and identify root causes of claim holds.
- Develop corrective action plans.
- Establish quality checkpoints before claim submission.
- Monitor hold rates and improvement metrics.
- Report trends and recommendations to stakeholders.
- Key Deliverables:
- Claims hold reduction strategy
- Root cause analysis reportKPI dashboard
- Monthly performance review Requirements:
- Strong knowledge of medical coding, including ICD-10, CPT, HCPCS, modifiers, and documentation requirements.
- Certification in Medical Coding and Billing
- Demonstrated experience with coding validation, auditing, and claim correction.
- Experience working within medical billing and revenue cycle environments.
- Familiarity with Athena or similar electronic health record/revenue cycle platforms.
- Interest or experience in AI-assisted coding, coding automation, or healthcare technology.
- Strong analytical and problem-solving skills.
- Excellent communication and collaboration skills.
- Experience developing training materials, SOPs, workflows, or staff education programs.
- The ability to translate complex coding requirements into practical guidance for billing and clinical teams.
- A strong understanding of healthcare regulatory and coding compliance requirements.
Level
SeniorL5
Salary
$25.00 - $33.00 per hour
Location
Brooklyn, NY
Occupation
Health Information Technologists and Medical Registrars
Industry
Administrative Management and General Management Consulting Services
Posted
2 days ago
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