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Senior Medical Coding Specialist - Workers' Compensation Experience

Claritev

Be part of a dynamic team innovating in healthcare cost management. As a Senior Medical Coding Specialist, you will review and analyze complex inpatient, outpatient, and practitioner claims for medical appropriateness and billing accuracy. Apply national and international coding standards and support daily operations and mentorship within coding teams. Serve as a subject matter expert for clinical and coding questions, collaborate with physicians and analytics teams to improve coding practices, and ensure compliance with HIPAA and international data regulations.

This role requires deep expertise in Workers' Compensation claims and advanced knowledge of coding systems including UB-04, CPT, HCPCS, ICD-10 and familiarity with international coding systems. You will manage complex claims independently, contribute to process improvements, and mentor new and existing staff.

Requirements & Qualifications
  • Minimum of 2+ years of Workers' Compensation coding experience
  • Current coding certification (AHIMA or AAPC) or active medical license (RN, MD) required
  • 7+ years of experience in clinically related fields (coding, auditing, nursing, radiology, lab, pharmacy, PA roles)
  • Extensive knowledge of inpatient and outpatient billing including UB-04, revenue codes, CPT, HCPCS, ICD-10, DRG, and APCs
  • Familiarity with international coding systems preferred
  • Strong understanding of payer reimbursement, medical necessity criteria, and regulatory standards
  • Experience with auditing and health information management preferred
  • Proficient in Microsoft Office (Excel, Outlook, PowerPoint); Visio a plus
  • Strong analytical, problem-solving, and communication skills
  • Ability to develop training materials and support knowledge sharing
  • Ability to manage multiple priorities and work independently
  • Flexibility to work evenings or weekends as needed
Benefits & Perks
  • Medical, dental, and vision coverage with low deductibles and copays
  • Life insurance
  • Short and long-term disability
  • Paid Parental Leave
  • 401(k) with company match
  • Employee Stock Purchase Plan
  • Generous paid time off accrued by years of service
  • 10 paid company holidays
  • Tuition reimbursement
  • Flexible Spending Account
  • Employee Assistance Program
  • Sick time benefits per state law

Friendly and supportive work environment with flexible schedules and professional development opportunities.

Location

N/A

Employment Type

Full-time

Experience Level

Senior

Salary Range

$70,000 - $90,000

Remote work allowed

Yes

Posted

4 weeks ago

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