Medical Coding Escalation Specialist

Job Summary

The full-time Medical Coding Escalation Specialist will manage complex coding issues, resolve escalated coding-related concerns, and provide expert-level support to the medical coding team in a remote setting.

Key responsibilities

• Review and resolve escalated coding issues from coders, auditors, billing teams, and providers
• Analyze medical records to ensure accurate and compliant code assignment
• Serve as a subject matter expert in coding guidelines and payer-specific rules

Required qualifications

• Minimum 3-5 years of experience in medical coding, focusing on complex case review or coding quality assurance
• AAPC or AHIMA certification is required
• Expert-level knowledge of ICD-10-CM, CPT, and HCPCS coding systems
• Strong understanding of CMS regulations and payer-specific guidelines
• Experience with electronic health records (EHRs) and coding software systems