Payer-Side Medical Coder & Claims Specialist

Sierra Solutions; United States; Sur place; USD 60 000 - 80 000; Plein temps

Résumé du poste

Sierra Solutions is seeking experienced Certified Medical Coders specializing in payer-side health care operations. The role focuses on accurate coding across CPT, HCPCS, and ICD-10-CM, with claims review and adherence to payer guidelines.

Ideal candidates will have CPC or CCS certification and hands-on experience with claims processing, benefits administration, and collaboration across claims and clinical teams to ensure compliant, efficient reimbursements.

Qualifications

• Active CPC or CCS certification or equivalent.
• Experience coding in payer, health plan, or reimbursement environments.
• Strong knowledge of ICD-10-CM, CPT, HCPCS.
• Understanding of claims processing and benefits administration.
• Ability to interpret medical documentation and guidelines.

Responsabilités

• Perform and review medical coding activities using CPT, HCPCS, ICD-10-CM.
• Review claims and documentation for coding accuracy and compliance.
• Apply payer-specific coding and reimbursement guidelines.
• Identify and resolve coding discrepancies and billing issues.
• Interpret medical records and employer benefit plans.
• Collaborate with claims, clinical, and operations teams to resolve issues.
• Support auditing, QA, and process improvements.
• Stay updated with coding guideline changes.

Connaissances

CPC

CCS

payer-side coding

ICD-10-CM

CPT

HCPCS

claims processing

benefits administration

attention to detail

communication skills

Formation

Active CPC/CCS certification or equivalent

Description du poste

Sierra Solutions is seeking experienced Certified Medical Coders specializing in payer-side health care operations. The role focuses on accurate coding across CPT, HCPCS, and ICD-10-CM, with claims review and adherence to payer guidelines.

Ideal candidates will have CPC or CCS certification and hands-on experience with claims processing, benefits administration, and collaboration across claims and clinical teams to ensure compliant, efficient reimbursements.