About the medical coding role
Most coding denials are not exotic. They come from E/M levels the note doesn't support, missing or misapplied modifiers, diagnosis codes that don't establish medical necessity, and add-on codes billed without the documentation they need. As a certified medical coder at CredSpun, you review outpatient encounters before charges go out so those claims are right the first time.
You will code for several outpatient practices — primary care, psychiatry, behavioral health, nurse practitioners and pediatrics most often — and you will be the person billers and account leads turn to when a payer questions a code.
What you will do
- Assign CPT, HCPCS Level II and ICD-10-CM codes from provider documentation
- Select E/M levels using the 2021+ office visit guidelines (medical decision making or total time)
- Apply modifiers correctly and check claims against NCCI procedure-to-procedure edits and MUEs
- Code psychiatric and psychotherapy services, including interactive complexity and psychotherapy add-on codes
- Send clear, compliant queries to providers when documentation is incomplete
- Review coding-related denials and recommend corrections or appeals
- Run periodic internal audits on a sample of encounters and share findings with the account lead
- Keep up with annual CPT and ICD-10-CM updates and payer-specific policies
What you need
- An active coding credential: CPC, COC, CCS or CCS-P
- Two or more years of outpatient or professional-fee coding
- Strong E/M coding under the current guidelines
- Working knowledge of NCCI edits, LCDs/NCDs and medical necessity
- Comfort working in several EHRs and switching between practices in a day
Helpful, not required
A specialty credential (for example CEMC or a behavioral health coding background), experience coding telehealth with place-of-service and modifier rules, and auditing experience.
Working remotely at CredSpun
This is a fully remote, work-from-home role open to applicants living in the United States. You work during U.S. business hours alongside a named account team, inside each client practice's own EHR and practice management system, with every login tied to you personally. You need a quiet, private workspace, a reliable broadband connection and a computer that can run a current browser and a second monitor. HIPAA training is part of onboarding, and you sign our confidentiality terms before you are given access to any patient data.