Certified coder

Certified Coder - Billing

Onsite - Royal Oak, MI

About Sciometrix

Sciometrix is a leading digital Health company looking for RN Case Manager Spanish. We are a leader in Telehealth -healthcare Virtual care Management. Our mission to engage patients to Deliver better outcomes. Sciometrix is known among customers, peers, and patients for clinical excellence, patient experiences, and provider satisfaction. Since the inception of our patient count, technological solutions have been evolving.

We empower healthcare providers with advanced technology and human expertise, revolutionizing a patient's experience. Our propriety software and related technologies ensure HIPAA compliancy with cloud access. We have established HIPAA-compliant Clinicus, an artificial intelligence (AI) bot that monitors patients 24/7 and ensures fast response in their care management program. Clinicas watches each patient's vitals and alerts our licensed team when a patient's program progress or vitals are varying. Our team will then quickly contact the patient to discuss the change. If needed, we will schedule a physician's appointment .

What's in it for you?

• Purpose-Driven Work
  
  

Play a key role in supporting accurate and compliant billing for telehealth services, directly contributing to better healthcare outcomes.

• Growth Opportunities
  
  

Advance your career in a growing company that values upskilling, cross-functional collaboration, and continuous learning.

• Team-Centered Culture
  
  

Be part of a supportive and collaborative team that values transparency, respect, and professional development.

• Access to Leadership
  
  

Work closely with leadership and decision-makers in an environment where your input is valued and your impact is visible.

• Stability and Structure
  
  

Enjoy a consistent, full-time schedule with the benefit of working onsite at our Sciometrix location, where structure and teamwork drive results.

• Exposure to Innovative Healthcare Models
  
  

Gain hands-on experience with evolving billing models like telehealth, CCM, and RPM, staying ahead of industry trends.

• Benefits: Paid time off, Paid Holidays, 401k with company-paid contributions, Medical, Vision, and Dental Insurance, Royal Oak, MI downtown Paid Parking.
  
  

About The Role

We are seeking a detail-oriented and credentialed Certified Coder to join our Pre-Billing RCM team. This role is critical in ensuring the accuracy and compliance of medical coding for telehealth services prior to claim submission. The ideal candidate will have hands-on experience with coding, billing guidelines, payer-specific requirements, and telehealth regulations.

Key Responsibilities

• Review clinical documentation and patient encounters for completeness and accuracy before claims submission.
• Assign appropriate ICD-10, CPT, HCPCS, and modifier codes in compliance with telehealth and payer guidelines.
• Validate coding to ensure medical necessity, compliance, and payer-specific rules.
• Work closely with physicians, nurse practitioners, and clinical teams to clarify documentation when needed.
• Flag discrepancies or missing information to reduce claim denials and rejections.
• Assist the Pre-Billing team in identifying coding trends and recommending process improvements.
• Ensure compliance with HIPAA, CMS, and telehealth coding standards.
• Collaborate with billing and AR teams to support clean claims and improve first-pass acceptance rate (FPAR).
• Stay updated with regulatory changes, payer policies, and industry best practices in telehealth coding and billing.
  
  

Required Qualifications

• Certification: CPC, COC, CCS, or equivalent coding certification (AAPC/AHIMA recognized).
• Experience: 2–4 years in medical coding with at least 1 year in telehealth or outpatient services preferred.
• Strong knowledge of ICD-10-CM, CPT, HCPCS Level II coding.
• Familiarity with payer-specific billing requirements (Medicare, Medicaid, and Commercial, CCM , RPM).
• Working knowledge of EMR/EHR systems and billing software.
• Excellent communication and documentation skills.
• High attention to detail and ability to work in a deadline-driven RCM environment.
  
  

Preferred Skills

• Experience in telehealth-specific coding, professional CPT coding and modifiers.
• Knowledge of pre-billing audit processes and denial management trends.
• Strong analytical and problem-solving skills.
• Ability to work independently and as part of a collaborative team.
  
  

Equal Opportunity: Sciometrix is committed to being an Equal Opportunity Employer, providing equal employment opportunities to all individuals .Sciometrix is committed to being an Equal Opportunity Employer, providing equal employment opportunities to all individualsC

Skills: telehealth,payer,hipaa,documentation,ccm,healthcare,compliance