Senior Medical Coding Specialist

2 weeks ago

Boston, Massachusetts, United States CODAMETRIX Full time
Position Overview

CodaMetrix is at the forefront of transforming Revenue Cycle Management through its innovative AI-driven autonomous coding platform, designed to convert clinical data into precise medical codes. Our solution enhances patient care and promotes operational efficiency across various care models.

We are dedicated to allowing healthcare professionals to focus on patient care rather than administrative tasks.

Role Summary

The Senior Medical Coding Specialist will report directly to the Director of Quality and Data Analytics. This role is pivotal in ensuring that our clients' coding quality standards are upheld while contributing to ongoing quality enhancement for our internal offerings.

The Quality and Data Analytics team is in search of a Senior Medical Coding Specialist with extensive expertise in medical coding, billing, and auditing. This position encompasses all aspects of coding, from initial assessments to final evaluations, including auditing coding outputs, identifying quality and workflow needs for clients, exploring automation enhancement opportunities, and acting as a subject matter expert on medical coding for our Machine Learning and Product teams.

The Senior Medical Coding Specialist will collaborate to develop training materials and share insights both within and outside the Quality and Data Analytics team regarding medical coding and billing practices. They will also engage in customer onboarding, serving as a coding quality liaison between clients and internal teams.

Key Responsibilities
  • Evaluate and document the coding methodologies, workflows, and quality expectations of clients to facilitate the implementation of CodaMetrix products and recommend potential improvements.
  • Oversee Coding Quality Assurance (CQA) initiatives, including audit assignments and the training and quality assurance of coding personnel.
  • Contribute to the creation of comprehensive medical coding and billing training resources to be shared across the organization.
  • Act as the company’s Subject Matter Expert for inquiries related to medical coding and billing.
  • Stay informed on the latest developments in medical coding and billing.
  • Advance the CQA team by continuously seeking and sharing innovative ideas and solutions.
  • Share knowledge with the CQDA team regarding coding and billing practices.
  • Serve as the coding expert for the Machine Learning and Product teams.
  • Collaborate with the Implementation team to ensure client quality and workflow requirements are met.
Qualifications
  • Current coding credential from AHIMA or AAPC held for a minimum of three years.
  • At least three years of experience in coding and auditing with progressive responsibilities, particularly in Radiology.
  • Exceptional communication and customer service abilities.
  • Analytical mindset with a focus on problem-solving, root cause analysis, and process enhancement.
  • Proficient in communicating with both technical and non-technical audiences, including those with varying levels of medical coding knowledge.
  • Detail-oriented with a commitment to accuracy and excellence.
  • Intellectual curiosity and creativity combined with critical thinking skills.
  • Able to perform efficiently under pressure in a dynamic environment.
  • A positive and collaborative team player.
Preferred Qualifications
  • CPMA or equivalent AHIMA credential.
  • Experience in medical billing, including knowledge of denials and payer policies.
  • Background in supervisory roles or project management.
  • Data analysis skills to identify coding risks, trends, or reimbursement opportunities.
  • Prior experience with startups or software companies.
  • Familiarity with CAC systems.

Employee Benefits

Discover how we support our team members.

  • Insurance: We cover a significant portion of medical and dental insurance costs and provide vision insurance.
  • Retirement: CodaMetrix offers a 401(k) plan available to eligible employees shortly after their start date.
  • Life Insurance: Employer-paid life insurance along with short-term and long-term disability coverage is provided.
  • Flexibility: Our unlimited PTO policy allows you to take the necessary time to recharge.
  • Learning: New hires participate in a comprehensive 7-week Fellowship program to gain insights into all departments.
  • Career Development: We conduct annual performance reviews and outline clear paths for advancement.
  • Engagement: We organize regular events such as Meditation Mondays and team socials.
  • Recognition: We celebrate our team’s achievements through quarterly awards and service milestones.

Background Check

All candidates must complete a background check upon acceptance of a job offer.

Equal Employment Opportunity

CodaMetrix values diverse skills, perspectives, and ideas, enhancing our company and products. We are an Equal Employment Opportunity Employer, and all qualified applicants will be considered for employment.

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