Provide SME on Payment Integrity edits and reimbursement policies.
Analyze data mining results to identify payment issues.
Ensure payments align with industry standards, internal policies, and regulations.
Respond to inquiries and disputes about policies and edits.
Document coding rules and draft reimbursement policy language.
Translate standards into business requirements and drive changes.

🎯 Requirements

Bachelor's degree or 4+ years of relevant experience.
4+ years in claims processing, coding, auditing, or health care ops.
4+ years experience in medical coding.
Coding certifications (AAPC CPC/COC or AHIMA).
Experience with reimbursement methods and provider contracts.
3+ years independent, driving projects to completion.

🎁 Benefits

Base pay: $88,800 - $116,550/year.
Full-time benefits: medical, dental, vision; 11 holidays; 401(k).
Unlimited vacation and annual performance bonuses.

Apply on employer's website

This employer gathers applications via their own applicant tracking system.

You will be redirected to an external application form.

Share job

Meet JobCopilot: Your Personal AI Job Hunter

Automatically Apply to Operations Jobs. Just set your preferences and Job Copilot will do the rest — finding, filtering, and applying while you focus on what matters.

Activate JobCopilot