Related skills
cms sql fhir cpt medicare📋 Description
- Interpret CMS/AMA/CPT and payer policies into actionable claims edits
- Use data-driven insights to identify policy opportunities
- SME across Medicaid, Medicare, and commercial lines - coding, billing, and reimbursement
- Collaborate with Product and Engineering to improve tooling and workflows
- Stay current on healthcare regulations to keep Rialtic's logic compliant
- Thrive in a remote, outcomes-driven environment and exceed targets
🎯 Requirements
- Bachelor's degree preferred in Healthcare, Technology, or related field
- 4+ years in healthcare coding, billing, or payment accuracy
- National coding credential: CPC, CCS-P, RHIA, CCS, CPB or equivalent
- Deep familiarity with CMS policies (LCAs, LCDs, NCDs), CCI edits, OIG alerts, fee schedules
- Strong understanding of claims processing workflows (CMS-1500, UB-04)
- SQL skills for data validation or analysis (nice to have)
🎁 Benefits
- Remote-first flexibility and home office stipend
- Meaningful equity and 401(k) match
- Open and Flexible PTO Plan, comprehensive medical/dental/vision plans
- Wellness reimbursements and access to TalkSpace, Teladoc, and One Medical
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