We are seeking a highly experienced Senior Medical Coding Consultant to support complex coding audits, compliance initiatives, and documentation improvement efforts for a leading AI-driven healthcare data company.

This role acts as a Subject Matter Expert (SME), partnering with clinical, coding, and revenue cycle teams to improve coding accuracy, ensure compliance, and optimize reimbursement outcomes.

Key Responsibilities:

Perform advanced coding using ICD-10-CM, CPT, and HCPCS for complex cases
Conduct coding audits and compliance reviews across inpatient and outpatient settings
Identify documentation gaps and recommend improvements
Provide consulting on coding operations and revenue cycle optimization
Develop and deliver training for coders, clinicians, and billing teams
Mentor junior coders and support quality improvement initiatives
Assist with denials, appeals, and revenue recovery
Interpret and apply CMS guidelines and payer policies
Support audits, transitions, and regulatory reviews
Contribute to Clinical Documentation Improvement (CDI) initiatives

Required Qualifications:

10+ years of medical coding experience
Active certification: CPC, CCS, RHIT, or RHIA
Deep expertise in ICD-10-CM, CPT & HCPCS, CMS guidelines and payer policies
Strong experience in coding audits & compliance, training and mentoring, healthcare consulting/advisory
Familiarity with EHR/EMR systems
Strong knowledge of HIPAA and compliance standards

Preferred:

Experience in CDI programs
Background in revenue cycle optimization
Experience working with health systems or consulting firms
Additional certifications (e.g., CPMA, CRC)