Medical Coder II/III

Overview

Reporting to the Senior Manager, Medical Coding & Audit, as a Senior Medical Coding Analyst, this role will be a key member of the team responsible for ensuring that CodaMetrix meets—and exceeds—our customers’ coding quality expectations. They will leverage their strong background in coding, billing, and auditing across service lines to review, analyze, and enhance coding processes, both internally and externally. They will play a pivotal role in improving the quality and efficiency of coding operations by collaborating closely with cross-functional teams, including Machine Learning, Product, and Customer Implementations. This role requires a proven ability to communicate highly complex coding issues and solutions to a wide range of stakeholders, alongside an unwavering commitment to continuous learning, quality, and innovation in medical coding practices.

Key Responsibilities

• Customer & Workflow Analysis: Analyze and document customers’ coding practices and workflows to facilitate optimal use of the CodaMetrix product. Identify and share best practices for coding automation and workflow improvements.
• Coding Quality Management: Assist manager with Coding Quality Assessment (CQA) projects, including work assignments, training, and quality assurance for offshore coding staff. Leverage CodaMetrix coding standards to drive world-class coding quality and consistency. Present audit results to customer stakeholders and facilitate sign-off for go-live milestones.
• Subject Matter Expertise: Serve as the internal and external Subject Matter Expert (SME) on medical coding and billing across assigned service lines, with a strong emphasis on coding for the specified service line. Provide expert guidance on coding and billing questions to support Machine Learning and Product teams.
• Collaboration & Knowledge Sharing: Develop and deliver evaluation and training materials on coding and billing to colleagues and customers. Share knowledge throughout CodaMetrix to build internal competencies and champion continuous improvement initiatives.
• Compliance & Professional Development: Proactively stay up to date with changes in medical coding and billing by maintaining relevant certifications and participating in ongoing education. Uphold all legal and ethical requirements, ensuring accuracy, confidentiality, and compliance in all coding and audit activities.
• Customer Implementation Support: Actively participate in customer implementations, providing coding expertise to ensure accurate and efficient deployment of CodaMetrix solutions. Collaborate with cross-functional teams—such as Data Science, Product, and Customer Success—to address client needs and optimize results.

Qualifications & Experience

• Current AHIMA or AAPC coding credential held for 5+ years.
• 5+ years of coding and auditing experience with progressive growth in responsibilities.
• CPC, CCS, and/or CIRCC certification (radiology-specific) is required.
• Candidates must have demonstrated experience with CPT coding in pathology; experience supporting or coding within radiology is strongly preferred.
• Excellent communication and customer service skills, capable of effectively engaging executives, directors, data scientists, and other stakeholders with varying levels of coding knowledge.
• Strong organizational and detail-oriented approach with a demonstrated commitment to excellence and precision.
• Critical thinking, intellectual curiosity, and creativity in problem-solving.
• Ability to thrive under time constraints in a fast-paced environment.