LTC Medical Coding Policy Expert – Remote

Gainwell Technologies; Wisconsin; On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Flexible vacation policy

Educational assistance

Leadership and technical development**

Job summary

Gainwell Technologies seeks a Long-Term Care Medical Coding Policy SME to support Wisconsin Medicaid LTC programs through medical coding analysis, policy implementation, and MMIS collaboration. You will review CPT, HCPCS, and ICD-10 updates, respond to policy inquiries, and work with providers and stakeholders to ensure compliant guidance and reimbursement policies.

The role requires strong coding expertise, project management, and ability to lead cross-functional initiatives in a

Qualifications

• Experience with CPT, HCPCS Level II, ICD-10 coding and reimbursement policy.
• Strong written and verbal communication for policy interpretation.

Responsibilities

• Review CPT, HCPCS Level II, and ICD-10 code set updates and assess impacts on waiver programs and Medicaid processes.
• Serve as medical coding SME for LTC coding workgroups and MMIS projects.
• Research and respond to complex coding and policy inquiries with cross-functional teams.
• Lead meetings, facilitate stakeholder discussions, and document actions and decisions.
• Maintain and enhance coding policy documentation and guidance.

Skills

CPT/HCPCS/ICD-10 knowledge

Medical coding expertise

Reimbursement policy understanding

Claims processing knowledge

Provider enrollment experience

Healthcare operations

Medicaid programs familiarity

Education

CPC/COC/CCS/RHIA/RHIT certifications

Tools

Microsoft Office (Excel, Word, PowerPoint, Teams, SharePoint)

Job description

Gainwell Technologies seeks a Long-Term Care Medical Coding Policy SME to support Wisconsin Medicaid LTC programs through medical coding analysis, policy implementation, and MMIS collaboration. You will review CPT, HCPCS, and ICD-10 updates, respond to policy inquiries, and work with providers and stakeholders to ensure compliant guidance and reimbursement policies.

The role requires strong coding expertise, project management, and ability to lead cross-functional initiatives in a