The Medical Coding Specialist provides coding expertise to support utilization management operations, health plan implementations, prior authorization program development, and clinical policy initiatives.
This role researches, analyzes, and interprets HCPCS, CPT, and ICD-10 coding guidance to support accurate prior authorization requirements, coding resources, and client deliverables across Medicare, Medicaid, Commercial, and Marketplace lines of business. The position partners with clinical, operational, compliance, business development, and client teams to ensure coding recommendations are accurate, compliant, and operationally sound.
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), or equivalent coding certification required/accepted
- High school diploma or equivalent required
- Associate's or Bachelor's degree in Health Information Management, Healthcare Administration, or related field preferred
- Minimum of 3 years of medical coding experience
- Experience with HCPCS, CPT, and ICD-10 coding required
- Experience supporting health plans, utilization management, prior authorization, DMEPOS, or payer operations preferred
- Knowledge of Medicare, Medicaid, and Commercial coding methodologies preferred
- Experience reviewing CMS guidance and payer policies
- Competitive compensation and annual bonus program
- 401(k) retirement program with company match
- Company-paid life insurance
- Company-paid short-term disability coverage
- Medical, vision, and dental benefits
- Paid time off (PTO)
- Paid parental leave
- Sick time
- Paid company holidays and floating holidays
- Quarterly company-sponsored events
- Health and wellness programs
- Career development opportunities
Location
N/A
Employment Type
Full-time
Experience Level
Intermediate Level
Salary Range
$65,000 - $65,000
Remote work allowed
Yes
Posted
1 month ago