Medical Coder – Virtual Clinic (AWV & HEDIS Gap Closure) - Remote
Medical Coder – Virtual Clinic (AWV & HEDIS Gap Closure) - Remote CareTalk Health CareTalk Health is a virtual medical practice that specializes in Clinical Process Outsourcing (CPO). We partner with healthcare organizations to build and manage patient and member populations.
About the Role
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. Schedule: Monday-Friday 9-5:30pm EST What You’ll Do What We’re Looking For Key Responsibilities 1) Encounter Coding and Review
- 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.
2) HEDIS Gap-Closure Coding
- 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.
3) Documentation Audit
- Review charts for missing ICD-10 codes, incomplete AWV elements, and unsupported diagnoses.
- Provide feedback to providers and nursing staff on documentation deficiencies.
4) Compliance and Quality Assurance
- Ensure adherence to CMS, HEDIS, and telehealth coding guidelines.
- Participate in internal coding audits and quality reviews.
5) Provider and Staff Support
- Serve as a coding resource for providers, nurses, and quality teams.
- Assist with coding education and documentation improvement.
Key Performance Indicators (KPIs)
- Coding accuracy rate ≥95%
- Charts coded within 24–48 hours
- Denial rate related to coding errors
- HEDIS gap closure supported by accurate coding
Required
- CRC, or equivalent outpatient coding certification
- Minimum 2 years outpatient or telehealth coding experience
- Experience with Medicare AWV and HEDIS measures
- Familiarity with telehealth billing rules
Preferred
- Medicare Advantage or risk-adjustment experience
- Experience in a virtual or high-volume clinic
- Knowledge of CCM, RTM, or APCM programs
Technical Requirements
- Proficiency with EHR and coding systems
- Basic Excel or reporting skills
- Ability to work in a remote, high-volume environment
Core Competencies
- Strong CMS and HEDIS coding knowledge
- Attention to detail and compliance
- Independent remote work capability
- Strong communication with clinical teams
Technical Requirements: · Computer: Windows or Apple Computer ONLY · 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 · Browser and System: Use Google Chrome with Amazon Workspaces (regardless of computer type). · Video Capability: Required for video calls. · Recommended Equipment: A second monitor is suggested for laptop users; dual monitors for PC users. Why CareTalk Health CareTalk Health is a fast-growing telehealth organization that delivers high-quality virtual care at scale. This role offers the opportunity to shape contractor operations, influence performance outcomes, and support innovative care models across a nationwide clinical workforce. CareTalk Health is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Pay: $30.00 per hour Work Location: Remote