RN Medical Coding Consultant

Job Summary

Leading cross-functional initiatives, the full-time RN Medical Coding Consultant will research and develop clinical services, manage episodic projects, and support the implementation of medical policies and coding practices while working remotely.

Key responsibilities

• Research and maintain coding systems, including CPT, CDT, HCPCS, and ICD-10, to meet business needs
• Independently manage complex projects and draft/revise medical policies based on evidence-based practices
• Prepare recommendations for internal and external audits while collaborating with various departments to support clinical initiatives

Required qualifications

• Current, non-restricted clinical license
• Bachelor's Degree in Nursing is required; Advanced Practice Provider degree is preferred
• Minimum of 5 years in a clinical setting with experience in medical coding, preferably in managed care
• Certification from the American Association of Professional Coders (AAPC) in Medical Coding is required
• Strong working knowledge of claims administration and healthcare data analysis