Critical Care Coder

Job Description

Job Description

Professional Fee Critical Care Coder (Remote)

Position Overview

We are seeking an experienced Professional Fee Critical Care Coder to join one of the largest health systems in the Chicago area. This role is responsible for performing 100% concurrent and retrospective reviews of physician Critical Care claims to ensure documentation accurately supports the level of service billed while maintaining compliance with CMS, AMA, and payer guidelines.

The ideal candidate has recent Professional Fee Critical Care coding experience , a strong understanding of Hospitalist Evaluation & Management (E/M) coding, and experience auditing physician documentation for accurate reimbursement.

Responsibilities

• Perform 100% concurrent and retrospective reviews of physician Critical Care claims assigned through Epic workqueues.
• Review provider documentation and assign accurate ICD-10-CM, CPT, and HCPCS codes for:
  • Critical Care
  • Hospital Inpatient Services
  • Observation Services
  • Evaluation & Management (E/M) Visits
• Audit physician documentation to ensure Critical Care services meet clinical criteria and time-based billing requirements (99291 & 99292) .
• Identify unsupported Critical Care services and appropriately downcode or query providers when documentation does not support billing.
• Manage assigned Epic workqueues while maintaining efficient claim turnaround and minimizing accounts receivable delays.
• Balance complex Critical Care audits with routine Hospitalist inpatient E/M coding based on daily department needs.
• Apply CMS, AMA, payer, and internal coding guidelines to ensure compliant physician billing.
• Review coding edits and help reduce billing denials through accurate documentation review.
• Maintain departmental productivity and quality standards while working independently in a remote environment.

Qualifications

Required

• 1-2+ years of Professional Fee Critical Care coding experience.
• Strong knowledge of Evaluation & Management (E/M) coding guidelines.
• Experience coding:
  • Critical Care
  • Hospital Inpatient Services
  • Observation Visits
  • Physician Professional Fee (PB) services
• Thorough understanding of Critical Care documentation requirements, including:
  • Time-based billing rules
  • Clinical indicators supporting Critical Care
  • Documentation compliance
• Epic experience.
• Must provide your own computer/equipment.
• Must have your own coding encoder.
• Ability to work independently in a high-volume remote environment.

Preferred

• Experience handling E/M denials and appeals .
• Experience responding to payer downcodes and medical necessity audits.
• CPC, CCS-P, COC, or equivalent coding certification.

Schedule

• Full-time
• Flexible 8-hour schedule
• Training will be 8:00 AM for the first two weeks.

Additional Information

• 100% Remote (Candidates must reside in Illinois, Indiana, or Wisconsin.)
• IT access typically takes 3-4 weeks following offer acceptance.
• Candidates must have their own computer/equipment

Why Join?

• Fully remote opportunity with one of the largest health systems in the Chicago area.
• Work in a highly specialized Professional Fee Critical Care coding role.
• Opportunity to strengthen auditing and physician documentation expertise.
• Career advancement opportunities within a nationally recognized healthcare organization.
• Collaborative coding team with a strong focus on quality, compliance, and professional development.

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

Company Description

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.

Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?

Company Description

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.\r\n\r\nOur commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?