Telehealth Medical Coder – CRC Certified – Remote (US)

About CareTalk Health

CareTalk Health is a virtual medical practice specializing in Clinical Process Outsourcing (CPO), partnering with healthcare organizations to manage patient and member populations nationwide.

Role Summary

The Medical Coder position involves precise and compliant coding of telehealth visits, primarily focusing on Medicare Annual Wellness Visits (AWVs) and HEDIS gap closure efforts, ensuring correct assignment of ICD-10, CPT, and HCPCS codes. The role supports quality measures, audit readiness, and adherence to CMS, HEDIS, and payer-specific protocols.

Work Schedule

Monday through Friday, 9:00 AM to 5:30 PM Eastern Standard Time.

Responsibilities

• Collaborate with CareTalk leadership to develop a compliant coding program enhancing accurate billing, regulatory compliance, and audit preparedness.
• Accurately code and review telehealth encounters, assigning ICD-10-CM diagnosis codes according to provider documentation.
• Apply CPT/HCPCS codes for initial (G0438) and subsequent (G0439) AWVs, ensuring telehealth modifiers and place-of-service codes are proper.
• Support HEDIS gap-closure by validating coding for measures such as CBP, EED, SPC, SUPD, OMW, BCS, GSD, KED, and COL.
• Identify incomplete or non-compliant documentation and provide feedback.
• Audit patient charts to detect missing codes, incomplete AWV components, and unsupported diagnoses; communicate findings to providers and nursing staff.
• Maintain compliance with CMS, HEDIS, and telehealth coding standards, participating in internal audits and quality reviews.
• Act as a resource for providers, nurses, and quality teams by offering coding education and improving documentation quality.

Performance Metrics

• Achieve at least 95% coding accuracy.
• Complete chart coding within 24 to 48 hours.
• Minimize denial rates related to coding errors.
• Support effective HEDIS gap closure through accurate coding practices.

Technical Requirements

• Use a Windows (minimum Windows 10) or Apple computer (MacOS 13 or higher); Chromebooks, Linux devices, and smartphones are not permitted.
• Wired headphones are required for clear audio during calls.
• Internet connection must meet minimum speeds of 50 Mbps download and 20 Mbps upload via wired Ethernet connection.
• Google Chrome browser is required alongside Amazon Workspaces software, regardless of computer type.
• Video capability via webcam is essential for video conferences; laptop built-in webcams or external webcams are acceptable.
• Dual monitors are recommended: two for PC users and an additional monitor for laptop users.

Candidate Qualifications

• Certified Risk Adjustment Coder (CRC) certification is mandatory.
• At least two years of outpatient or telehealth coding experience.
• Proven knowledge and experience working with Medicare Annual Wellness Visits (AWV) and HEDIS measures.
• Familiarity with telehealth billing regulations and requirements.
• Preferred: experience with Medicare Advantage or risk-adjustment coding, virtual or high-volume clinical settings, and knowledge of CCM, RTM, or APCM programs.
• Strong competency in CMS and HEDIS coding guidelines and attention to compliance details.
• Ability to work independently in a remote environment and communicate effectively with clinical teams.

Diversity & Compliance

CareTalk Health is committed to diversity, equity, and inclusivity, fostering an environment welcoming to all employees. California applicants should review the company’s privacy notice detailing information collection and privacy rights under state law.