At Revere Health, we believe there is a better path to healing and healthcare maintenance, and we’re working on this mission—one patient at a time. We’re a national leader in a movement called value-base care which aims to improve treatment outcomes and keep costs down. Our internal culture is one that promotes respect and consistently recognizes the impact that individual employees have on the mission of the organization.
Position Summary: The Revenue Cycle Compliance Coder performs detailed reviews of clinical documentation and coding to ensure services are billed accurately and in compliance with payer and regulatory requirements. This role focuses on identifying trends and systemic risk, not just individual errors, and supports payer audit defense and provider education efforts.
Essential Job Functions: Conducts pre-bill and post-bill compliance audits across specialties and payers. • Reviews E&M leveling, procedure coding, modifiers, and medical necessity. • Identifies patterns of risk by provider, specialty, and service-line. • Performs HCC coding review. • Documents findings in a clear and defensible manner. • Supports payer audits, refund requests, and internal investigations. • Participates in provider and coder education based on audit findings.
Qualifications: 5 or more years of professional coding experience, specialty medicine experience preferred. • Prior experience performing coding or compliance audits • Advanced knowledge of CPT, ICD 10 CM, HCPCS, modifiers, and payer policies • Ability to interpret medical records and apply coding guidelines consistently Required Certifications • CPC or CCS required Specialty certifications a plus
Hours: Hours: Monday - Friday 8am to 5pm Hybrid Position