Certified Medical Coding Specialist

To support Utilization Management operations, the full-time Certified Medical Coding Specialist will provide coding expertise, research coding guidelines, and ensure compliance across various health plan lines of business while working remotely. Key responsibilities Research, analyze, and interpret HCPCS, CPT, and ICD-10 coding guidance to support accurate coding decisions Develop and maintain Prior Authorization code lists and coding reference materials for health plan implementations Perform quality reviews of coding deliverables to ensure accuracy, completeness, and adherence to established standards Required qualifications Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), or equivalent certification High school diploma or equivalent required; Associate's or Bachelor's degree in a related field preferred Minimum of 3 years of medical coding experience, including HCPCS, CPT, and ICD-10 coding Experience with health plans, utilization management, and prior authorization preferred Knowledge of Medicare, Medicaid, and Commercial coding methodologies preferred