Mid Level Clinical Coder Jobs
Mid level clinical coder jobs go to professionals ready to own complex case assignments, mentor junior coders, and make confident coding decisions with minimal oversight. Roles are concentrated in Healthcare & Medical Services, Insurance, and Consulting & Professional Services, with a mix of on-site, hybrid, and remote opportunities, and employers like Optum, Gebbs Healthcare Solutions, and Banner Health hiring at this level now.
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Position: Medical Coder
Rate: $48.57
Location: Remote in IL only (Candidate must reside in IL)
Note: Looking for RN with an active license and coding certification (CPC, COC, CIC, CPMA, CCS, CCS-P or RHIT/RHIA)
Prefer:
- Behavioral Health coding and auditing experience.
- Knowledge of DSM-5 documentation requirements.
- Experience auditing mental health, substance use disorder, psychiatric facility, and behavioral health outpatient claims.
Description:
Investigates complex healthcare claims flagged by third-party referrals, tips, or external allegations prior to payment. This role combines advanced clinical coding expertise (ICD-10, CPT, HCPCS) with investigative scrutiny. The auditor reviews medical records to verify that documented services match the billed codes, adhere to medical necessity guidelines, and comply with state, federal, and contractual coding regulations.
Key responsibilities:
- Allegation Triaging & Investigation: Analyze incoming third-party referrals, compliance tips, and external fraud allegations to identify specific billing patterns, suspect providers, or unbundled services.
- Identify potential fraud, waste, abuse, billing irregularities, and patterns of non-compliance through medical record review and claims analysis.
- Pre-Payment Clinical Review: Perform comprehensive clinical and technical reviews of high-dollar or highly complex medical records before a claim is finalized for payment.
- Coding & Documentation Validation: Audit clinical documentation to ensure strict alignment with CPT, HCPCS, ICD-10-CM, ICD-10-PCS, and Official Coding Guidelines.
- Medical Necessity Assessment: Evaluate medical records against internal medical policies, prepare review summary as needed and work closely with Medical Directors.
- Prepare audit summaries and support referrals to Special Investigations Unit (SIU), Provider Performance, or Compliance teams when warranted.
Required Qualifications & Education:
- Education: Nursing RN, active license
- Core Coding Credentials: Must hold at least one active, nationally recognized coding certification:
- AAPC: Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC) or Certified Professional Medical Auditor (CPMA).
- AHIMA: Certified Coding Specialist (CCS), Certified Coding Specialist – Physician-based (CCS-P), or Registered Health Information Technician/Administrator (RHIT/RHIA).
- Experience: 5 years combined experience in clinical auditing, medical coding, payment integrity, SIU investigations, utilization management, or healthcare compliance, or related healthcare reimbursement functions, including medical record review and claims auditing.
Technical Expertise:
- Demonstrated proficiency in CPT, HCPCS Level II, ICD-10-CM, and medical record documentation review.
- Working knowledge of CMS reimbursement methodology, National Correct Coding Initiative (NCCI) edits, and applicable federal and state regulations.
Pay: From $48.57 per hour
Expected hours: 40.0 per week
Benefits:
- Referral program
Experience:
- clinical auditing and medical coding: 5 years (Required)
License/Certification:
- RN License (Required)
- Certificate-CPC, COC, CIC, CPMA, CCS, CCS-P or RHIT/RHIA (Required)
Location:
- Illinois (Required)
Work Location: Remote
Position: Medical Coder
Rate: $48.57
Location: Remote in IL only (Candidate must reside in IL)
Note: Looking for RN with an active license and coding certification (CPC, COC, CIC, CPMA, CCS, CCS-P or RHIT/RHIA)
Prefer:
- Behavioral Health coding and auditing experience.
- Knowledge of DSM-5 documentation requirements.
- Experience auditing mental health, substance use disorder, psychiatric facility, and behavioral health outpatient claims.
Description:
Investigates complex healthcare claims flagged by third-party referrals, tips, or external allegations prior to payment. This role combines advanced clinical coding expertise (ICD-10, CPT, HCPCS) with investigative scrutiny. The auditor reviews medical records to verify that documented services match the billed codes, adhere to medical necessity guidelines, and comply with state, federal, and contractual coding regulations.
Key responsibilities:
- Allegation Triaging & Investigation: Analyze incoming third-party referrals, compliance tips, and external fraud allegations to identify specific billing patterns, suspect providers, or unbundled services.
- Identify potential fraud, waste, abuse, billing irregularities, and patterns of non-compliance through medical record review and claims analysis.
- Pre-Payment Clinical Review: Perform comprehensive clinical and technical reviews of high-dollar or highly complex medical records before a claim is finalized for payment.
- Coding & Documentation Validation: Audit clinical documentation to ensure strict alignment with CPT, HCPCS, ICD-10-CM, ICD-10-PCS, and Official Coding Guidelines.
- Medical Necessity Assessment: Evaluate medical records against internal medical policies, prepare review summary as needed and work closely with Medical Directors.
- Prepare audit summaries and support referrals to Special Investigations Unit (SIU), Provider Performance, or Compliance teams when warranted.
Required Qualifications & Education:
- Education: Nursing RN, active license
- Core Coding Credentials: Must hold at least one active, nationally recognized coding certification:
- AAPC: Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC) or Certified Professional Medical Auditor (CPMA).
- AHIMA: Certified Coding Specialist (CCS), Certified Coding Specialist – Physician-based (CCS-P), or Registered Health Information Technician/Administrator (RHIT/RHIA).
- Experience: 5 years combined experience in clinical auditing, medical coding, payment integrity, SIU investigations, utilization management, or healthcare compliance, or related healthcare reimbursement functions, including medical record review and claims auditing.
Technical Expertise:
- Demonstrated proficiency in CPT, HCPCS Level II, ICD-10-CM, and medical record documentation review.
- Working knowledge of CMS reimbursement methodology, National Correct Coding Initiative (NCCI) edits, and applicable federal and state regulations.
Pay: From $48.57 per hour
Expected hours: 40.0 per week
Benefits:
- Referral program
Experience:
- clinical auditing and medical coding: 5 years (Required)
License/Certification:
- RN License (Required)
- Certificate-CPC, COC, CIC, CPMA, CCS, CCS-P or RHIT/RHIA (Required)
Location:
- Illinois (Required)
Work Location: Remote
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- Healthcare & Medical Services10
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- Consulting & Professional Services2
- Human Resources1
Mid Level Clinical Coder Jobs: Frequently Asked Questions
How do I get a mid level clinical coder job?
Position yourself by highlighting ownership of complex or high-volume coding assignments, proficiency with current code sets such as ICD-10-CM, CPT, and HCPCS, and any accuracy or productivity metrics you can cite. Emphasize experience across multiple specialties or facility types, relevant certifications like CCS or CPC, and examples where you caught errors or improved workflow without close supervision.
Which companies hire mid level clinical coders?
Companies hiring mid level clinical coders right now include Optum, Gebbs Healthcare Solutions, and Banner Health, based on current listings on Migrate Mate as of November 2026. At this level, hiring tends to come from health systems, large physician groups, revenue cycle management firms, and coding outsourcing companies that need coders who can work independently and handle complex documentation.
Are there remote mid level clinical coder jobs?
Yes, remote work is common at this level, partly because experienced coders can be trusted to maintain quality and productivity independently. About 95% of mid level clinical coder openings are remote or hybrid as of November 2026, reflecting how broadly healthcare organizations have adopted distributed coding teams for roles that don't require a physical presence.
How do I move up to a mid level clinical coder role?
Moving into a mid level clinical coder role typically means deepening your specialty knowledge, earning a recognized credential, and building a record of handling complex cases accurately without constant supervision. Taking on harder case types, volunteering for audits or quality reviews, and demonstrating that you can contribute to workflow improvements are the kinds of growth that signal readiness for more ownership.
Which industries hire the most mid level clinical coders?
Mid Level clinical coder roles concentrate in Healthcare & Medical Services, Insurance, and Consulting & Professional Services, based on current listings on Migrate Mate as of November 2026. These sectors drive demand because they handle high volumes of complex documentation, face strict reimbursement compliance requirements, and need experienced coders who can work independently across a range of diagnoses and procedures.