About The Role
Rex.zone connects certified medical coders in India with US healthcare revenue cycle workflows. In this full-time remote role, you will translate clinical documentation into compliant codes, apply payer and NCCI rules, and support clean claims with audit-ready notes while following HIPAA-aligned privacy and secure access controls.
Key Responsibilities
- Review clinical documentation (H&P, progress notes, operative reports, discharge summaries) for accurate code assignment
- Assign ICD-10-CM/PCS, CPT, and HCPCS codes with appropriate modifiers
- Validate medical necessity and documentation sufficiency; apply LCD/NCD guidance when applicable
- Resolve claim scrubber edits and rejections to improve first-pass claim acceptance
- Support denial prevention via root-cause analysis (coding, bundling, authorization, eligibility)
- Participate in audits and maintain audit trails; meet productivity, quality KPIs, and SLA turnaround times
- Maintain secure remote work practices and PHI handling consistent with HIPAA requirements
Required Qualifications
- 3+ years of production medical coding experience
- Strong knowledge of ICD-10-CM and CPT (ICD-10-PCS for inpatient roles)
- Experience with modifiers, NCCI edits, payer policies, and claim scrubber tools
- Ability to work with US time-zone overlap as required
Preferred Qualifications
- Certification such as CPC, CCS, COC, or CIC
- Specialty coding exposure (e.g., ED, surgery, anesthesia, radiology, cardiology, orthopedics)
- Exposure to HCC/RAF risk adjustment and compliance/audit methodologies
Compensation
$30–$50 per hour (based on assignment scope, specialty, and experience).
