Medical Coder – Virtual Clinic (AWV & HEDIS Gap Closure) - Remote

CareTalk Health

8h•Remote

About The Position

The Medical Coder is responsible for accurate and compliant coding of telehealth encounters, with a primary focus on Medicare Annual Wellness Visits (AWVs) and HEDIS gap-closure services. This role ensures proper assignment of ICD-10, CPT, and HCPCS codes, supports quality-measure capture, and maintains compliance with CMS, HEDIS, and payer-specific requirements.

Requirements

CRC Certification
Minimum 2 years outpatient or telehealth coding experience
Experience with Medicare AWV and HEDIS measures
Familiarity with telehealth billing rules
Computer: Windows or Apple Computer ONLY (NO Chromebooks, Linux Machines, or Smartphones) Must have at least Windows 10 or MacOS 13.
Headphones: Wired headphones required for optimal audio quality.
Internet Speed: Meet minimum internet speed requirements (50 MBPS download speed and 20 MBPS upload speed), with a wired connection to the router. Must have an ethernet cable connecting computer directly into router
Browser and System: Use Google Chrome with Amazon Workspaces (regardless of computer type).
Video Capability Required: Required for video calls. (Webcam) Laptops will come with a built in webcam which is fine. If it doesn’t you’ll need to get one.

Nice To Haves

Medicare Advantage or risk-adjustment experience
Experience in a virtual or high-volume clinic
Knowledge of CCM, RTM, or APCM programs
A second monitor is suggested for laptop users; dual monitors for PC users.

Responsibilities

Develop and implement a compliant coding program in collaboration with CTH leadership to support accurate billing practices, audit readiness, and regulatory compliance.
Assign appropriate ICD-10-CM diagnosis codes based on provider documentation.
Code CPT/HCPCS services for: Initial AWV (G0438), Subsequent AWV (G0439).
Ensure telehealth modifiers and place-of-service codes are correct.
Validate coding for HEDIS measures including CBP, EED, SPC, SUPD, OMW, BCS, GSD, KED, and COL.
Confirm diagnosis and procedure codes support measure closure.
Flag incomplete or non-compliant documentation.
Review charts for missing ICD-10 codes, incomplete AWV elements, and unsupported diagnoses.
Provide feedback to providers and nursing staff on documentation deficiencies.
Ensure adherence to CMS, HEDIS, and telehealth coding guidelines.
Participate in internal coding audits and quality reviews.
Serve as a coding resource for providers, nurses, and quality teams.
Assist with coding education and documentation improvement.