Healthcare Coding Expert (certified professional coder)

📋 Description

• Analyze complex medical claims data for fraud, waste, and abuse indicators.
• Identify trends and patterns; develop actionable leads and referrals.
• Review claims for coding accuracy, reimbursement, and policy adherence.
• Apply ICD-10, CPT, HCPCS knowledge to claims analysis.
• Research policies, standards, and regulatory requirements for investigations.
• Contribute to analytical reports and communicate findings to stakeholders.

🎯 Requirements

• Bachelor’s degree or equivalent experience.
• 8+ years in healthcare claims analytics or related field.
• Active CPC (AAPC) or CCS (AHIMA) certification.
• Knowledge of ICD-10, CPT, HCPCS; strong healthcare compliance.
• Experience in fraud, waste, and abuse activities; regulatory understanding.
• Data analysis with actionable insights; strong communication skills.

🎁 Benefits

• Competitive salary with location-based considerations.
• Comprehensive medical, dental, vision insurance; 401(k) with match.
• Paid time off and holidays; family leave; disability and life insurance.
• Flexible work arrangements and ~40 hours/week; ~10–25% travel.