Healthcare Coding Expert (certified professional coder)

📋 Description

• Analyze complex medical claims data to identify fraud, waste, and abuse indicators.
• Review claims for coding accuracy, reimbursement, and policy adherence.
• Apply ICD-10, CPT, HCPCS coding standards to claims analysis.
• Support investigations with policy research and regulatory insights.
• Communicate findings to stakeholders and contribute to analytic reports.
• Collaborate with multidisciplinary teams to ensure program integrity.

🎯 Requirements

• Bachelor’s degree or equivalent experience.
• 8+ years in healthcare claims analysis or related analytics.
• Active CPC or CCS certification (AAPC or AHIMA).
• Extensive knowledge of ICD-10, CPT, HCPCS, and medical terminology.
• Experience in fraud, waste, and abuse activities and audits.
• Strong communication, Excel, and analytical skills; familiarity with Tableau/Jira/Confluence.

🎁 Benefits

• Competitive salary range: $77,775–$105,225 (USD).
• Comprehensive health insurance, dental and vision options.
• 401(k) with company match; paid leave and holidays.
• Disability and life insurance; travel/accident coverage options.
• Flexible work arrangements and ~40 hours/week.
• Opportunity to contribute to high-impact healthcare program integrity initiatives.