Medical Coder

We are looking for a skilled Clinical Consultant to join our team on a contract basis.

This role focuses on supporting a strategic benefit digitization initiative, ensuring consistent and accurate coding practices across diverse markets. As part of a healthcare organization advancing its digital transformation, you will play a vital role in optimizing member and provider experiences while ensuring compliance with regulatory standards.

Responsibilities

• Apply standardized coding practices to interpret and digitize benefit structures effectively.
• Develop and manage groupings of procedures and service codes to ensure accurate alignment with benefit plans.
• Maintain and update industry-standard codes quarterly and annually, along with benefit plan modifications throughout the year.
• Execute coding solutions for benefit administration across multiple markets, including customized coding for nonstandard requests.
• Ensure coding practices comply with regulatory mandates and support updates as needed.
• Provide expert consultation on coding inquiries to project teams and business partners.
• Collaborate with cross-functional project teams to contribute coding expertise for successful implementations.
• Support benefit digitization initiatives by leveraging advanced coding methodologies and tools.
• Assist in designing and implementing digital capabilities that align with organizational goal