Job Summary

A direct hire opportunity is available for an experienced Certified Professional Coder based in Grand Island, NY. This role is ideal for a detail-oriented CPC professional with strong medical coding, fee schedule, bill review, and clinical documentation knowledge who wants to apply their expertise in a specialized legal, insurance, and forensic medical review environment.

The Certified Professional Coder will support complex medical bill review matters involving no-fault, workers' compensation, and personal injury claims. This position offers a remote work environment, flexible scheduling, and the opportunity to work independently while contributing to high-impact case analysis, reimbursement review, and legal documentation.

This is a strong fit for someone who values accuracy, autonomy, supportive leadership, and a collaborative professional team. The environment offers stability, work-life balance, comprehensive benefits, and the chance to use advanced coding knowledge in a meaningful and highly specialized setting.

Key Responsibilities

- Review physician and facility bills for compliance with NYS and/or NJ Workers' Compensation and No-Fault Fee Schedules.
- Audit medical bills, coding practices, and clinical documentation using industry-standard coding resources and databases.
- Evaluate medical necessity, coding accuracy, stabilization points, and appropriateness of billed services for complex medical claims.
- Identify billing discrepancies, including upcoding, unbundling, non-compliant billing practices, and charges outside fee schedule parameters.
- Prepare detailed counter-affidavits, affirmations, cost reports, and written findings for arbitration, litigation, and court submissions.
- Collaborate with internal teams and provider billing representatives while maintaining HIPAA compliance and strict confidentiality.

Compensation and Benefits

- Direct hire opportunity.
- Compensation: $50,000 to $70,000 per year.
- Schedule: Monday through Friday, 8:00 AM to 4:30 PM.
- Flexible schedule.
- Remote work environment.
- 401(k) with 3% company match.
- Health insurance options.
- Dental insurance.
- Health Savings Account.
- Life insurance.
- Disability insurance.
- 10 days PTO annually.
- 5 New York State sick days.

This company offers growth and a great group of people to work with.