Medical Coding Education Associate Sr (Hospital / Professional Claims) - Military Veterans

Position Overview

The Medical Coding Education Associate Sr (Hospital / Professional Claims) position is responsible for the comprehensive analysis of complex claims data to generate tailored, industry‐relevant concepts that drive success across business lines. Operating in a hybrid work environment (in‐office 1–2 days per week), this role fosters collaboration while promoting work-life balance. Candidates must be within a reasonable commuting distance unless an accommodation is provided.

Key Responsibilities

• Engage with providers and internal/external stakeholders to review coding and documentation guidelines.
• Examine medical records and related documentation to ensure precise code assignment.
• Research, validate, and stay current on coding, billing issues, trends, and regulatory changes to recommend effective concepts.
• Develop innovative concept ideas to support departmental and organizational goals.
• Generate new leads and launch education concepts.
• Provide comprehensive feedback on current coding guidelines to providers and assist associates with documentation and education discussions.
• Conduct phone and email correspondence to ensure providers fully understand the applicable coding and documentation guidelines.
• Review medical records in detail to confirm that the documentation justifies the level of service provided.
• Assist associates with completing medical record reviews and respond to provider inquiries.
• Process appeals requests from providers.
• Complete chart reviews and provide detailed education based on the records received.

Required Qualifications

• AA/AS degree with a minimum of 6 years’ experience with ICD‑9/10CM, CPT, and HCPCS coding, or an equivalent combination of education and experience.
• Current, valid, active, and unrestrictive RHIA or RHIT certification and/or certification as a Coding Specialist (CCS) or Professional Coder (CPC).

Preferred Qualifications

• Proficiency with MS Outlook, Word, and Excel.
• Experience in facility or professional health insurance reimbursement, medical coding, or coding audits.
• Understanding of health data analytics.
• Excellent oral and written communication skills, strong analytical and critical thinking abilities, and the capacity to manage multiple tasks in a demanding environment.

Benefits & Perks

• Compensation: The salary range for this position is $69,360 to $119,646, determined by factors such as geographic location, work experience, education, and skills.
• Benefits: Comprehensive benefits package including medical, dental, vision, disability insurance, 401(k) match, stock purchase plan, life insurance, wellness programs, and incentive bonus programs.
• Hybrid work environment with in-office presence 1–2 days per week complemented by flexible remote work options.