Description

Maximus is seeking two (2) Medical Billing & Coding Coordinators to support our Independent Bill Review (IBR) Program. This role is ideal for detail-oriented professionals who thrive in a fast-paced, high-volume environment.

In this role, you will ensure accurate case and coding data entry, review files for completeness, and prepare and validate IBR correspondence. You will identify gaps, request additional information, resolve discrepancies, and communicate with stakeholders to support efficient case processing. You will also ensure timely, compliant case handling while supporting system updates, redactions, and other IBR-related tasks.

This is a full-time, fully remote position within the United States.

Why Maximus? 

• Work/Life Balance Support - Flexibility tailored to your needs
• Comprehensive Insurance Coverage - Choose from various plans, including Medical, Dental, Vision, Prescription, and partially funded HSA. Additionally, enjoy Life insurance benefits and discounts on Auto, Home, Renter's, and Pet insurance
• Future Planning - Prepare for retirement with our 401K Retirement Savings plan and Company Matching
• Paid Time Off Package – Enjoy PTO, Holidays, and extended sick leave, along with Short- and Long-Term Disability coverage
• Holistic Wellness Support - Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP)
• Recognition Platform - Acknowledge and appreciate outstanding employee contributions
• Tuition Reimbursement - Invest in your ongoing education and development
• Employee Perks and Discounts - Additional benefits and discounts exclusively for employees
• Maximus Wellness Program and Resources - Access a range of wellness programs and resources tailored to your needs
• Professional Development Opportunities-Participate in training programs, workshops, and conferences
• Licensures and Certifications-Maximus assumes the expenses associated with renewing licenses and certifications for its employees

Essential Duties and Responsibilities:

• Abstract and code clinical data
• Audit medical records to ensure compliance with the organization's coding procedures and standards
• Accurately enter coded data in a system and validate data entered
• Research correct coding practices, clearly document and share findings with others
• Review denials and recommend billing corrections
• Train staff members on the coding process
• Enter and verify accurate case and CPT/HCPCS/DRG data
• Process IBR correspondences for the mail
• Review files for completeness and documentation
• Prepare and validate IBR correspondence
• Identify gaps, request information, and resolve discrepancies
• Communicate with stakeholders to support case processing
• Ensure timely, compliant case handling
• Support system updates, redactions, and other IBR tasks

Minimum Requirements:

• High School diploma or equivalent with 0 - 2 years of experience
• Additional clinical licensure may be required based on project
• At least 2 years of data entry experience
• Ability to perform mathematical calculations- Experience working with MS office applications (Excel, Word, etc.)
• Excellent organizational, interpersonal and verbal communication skills
• Strong analytical skills, including the ability to research issues
• Ability to work independently and collaboratively in a remote, fast-paced environment
• Willingness to work within a Pacific Time (PST) schedule as needed

 Preferred Requirements:

• Experience working in a medical office or healthcare setting
• Knowledge of claims processing and reimbursement practices
• Familiarity with CPT, ICD-9/10, HCPCS, and coding guidelines
• Understanding of claims adjudication rules and Medicare methodologies
•  Ability to review regulations to determine if exceptions exist that alter industry-standard payment rules

 Home Office Requirements:

• Maximus provides company-issued computer equipment
• Reliable high-speed internet service
• Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
• Minimum 5 Mpbs upload speeds