Certified Medical Coding Specialist

Job Summary

Providing expert coding guidance, the full-time remote Certified Medical Coding Specialist will ensure compliance with coding standards, support value-based reimbursement models, and mentor team members while developing resources for providers.

Key responsibilities

• Consults on proper coding rules in value-based contracts and strategizes solutions to maximize quality payments
• Acts as a technical resource for complex coding and billing issues, conducting analyses to ensure compliance with contracts
• Develops guides for providers on billing methodologies and collaborates with internal teams to improve processes and outcomes

Required qualifications

• Bachelor's Degree or 4 years of relevant work experience in addition to required experience
• CCS-Certified Coding Specialist or Certified Coder (CCS or CPC) certification required upon hire
• 5 years of experience in risk adjustment coding, ambulatory coding, or CRC coding in managed care or health insurance
• Knowledge of billing practices and value-based reimbursement models
• Experience in creating educational materials and training resources