• Certified Medical Coder

    Job Locations US-TX-Irving
    Posted Date 1 week ago(1 week ago)
    Requisition ID
    # of Openings
    Job Schedule
    Regular Full-Time
  • Responsibilities

    MAXIMUS is a leading operator of government health and human services programs and has partnered with state, federal and local governments to provide critical, high quality health and human service programs to a diverse array of communities. Operating under MAXIMUS’s founding mission of Helping Government Serve the People® since 1975, MAXIMUS Federal Services is entirely focused on helping government agencies run programs cost-effectively and serve program constituents with improved outcomes. By being a responsible steward for government programs, we help the federal government deliver on its promises through our people, process and technology. Our focus is always on outcomes and results that connect citizens more effectively with government services.

    This project will be supporting the National Medicare and Medicaid Correct Coding Initiative (NCCI), a Center for Medicare and Medicaid Services (CMS) initiative to prevent improper payments and promote consistent coding for national programs. The NCCI program functions to promote program integrity and compliance through guidance, edits, and other methodologies that promote the consistent administration of CMS payment policies in instances where the manipulation of coding could lead to inappropriate, increased reimbursements.


    Working remote is an option and would depend on experience, expertise and proven ability to meet workload standards.

    Job Duties:
    • Abstract and code clinical data
    • Audit medical records to ensure compliance with the organization's coding procedures and standards
    • Utilize specialized classification software to assign or validate procedure and diagnosis codes according to established policies and procedures
    • Reviews and abstracts the demographic, financial and clinical data from the medical record for the purpose of assigning ICD-9/10 diagnosis/procedures, HCPCS, CPT, modifiers and units
    • Verifies proper CPT and diagnosis coding is entered in the appropriate system based on the level of service provided and documented in the electronic health record by provider
    • Determine appropriate claims pricing/reimbursement methodology
    • Collaborate with the client to address policy issues that arise in the content of review Ensure process is being completed timely according to contract regulations
    • Abstract and sequence codes into encoder software and correct information that has been rejected, as well as correct any identified data errors or inconsistencies
    Education and Requirements:
    • High School Diploma or GED is required. An Associate’s degree from an accredited college or university is preferred.
    • At least five (5) years of Medical Coding experience required
    • Must have a current certification of RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator), CCS (Certified Coding Specialist) or CPC (Certified Professional Coder)
    • Experience in interpreting HCPCS / CPT codes and coding conventions
    • Experience in performing and interpreting computer analysis of Medicare Part B claims
    • Experience in working with Medicare Part B and Medicaid claims processing systems
    • Experience in interpreting/coding ICD-9-CM and ICD-10-CM codes and narrative, and linking ICD-9-CM and ICD-10-CM codes to procedure codes for medical necessity
    • Experience working with Medicare and Medicaid payment policies
    Additional Requirements:
    • Must be able to successfully clear the agency background check - National Agency Check and Inquiries (NACI) with fingerprinting
    • Must be a US Citizen

    The Ideal Candidate will Possess the Following Additional Education and Experience

    • High School Diploma with 0-2 years of experience.
    • May have additional training or education in area of specialization.
    • Works on assignments that are routine in nature, with responsibilities easily learned on the job.
    • Acquires job skills and learns applicable policies and procedures to complete routine tasks.
    • Able to read, understand & perform assignments within prescribed guidelines.
    • Communicates routine information in a clear and accurate way with internal & external contacts.

    EEO Statement

    EEO Statement: Active military service members, their spouses, and veteran candidates often embody the core competencies MAXIMUS deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We’re proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. MAXIMUS is an Affirmative Action/Equal Opportunity Employer. MAXIMUS provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.


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