Remote Coding SME: PB/ASC, Pathology & Radiology

Healthrise; Farmington Hills (MI); Hybrid; USD 90,000 - 130,000; Full time

Job summary

Healthrise is seeking a Coding Subject Matter Expert (SME) to act as an escalation-level coding resource across PB/ASC, Pathology/Radiology, or Primary Care specialties. This role collaborates with physicians to ensure accurate CPT/HCPCS/ICD-10 coding and keeps claims compliant, while mentoring junior staff and supporting audits.

The SME will navigate complex documentation questions, apply payer-specific policies, and stay updated on coding guidelines, with the flexibility to travel to client

Qualifications

• Active coding credential required (CPC/CCS/CCS-P/CASCC/CIRCC/CEMC or equivalent).
• Minimum 5 years coding experience in the assigned specialty.
• Experience communicating with physicians to resolve documentation and coding questions.
• Strong written/verbal communication and problem-solving skills.
• Proficiency with Epic or similar EHR/coding platforms.
• Ability to work independently on complex, escalated coding cases.
• Completion of regulatory certifications as required.
• Willingness to travel to client/sites as needed.

Responsibilities

• Serve as SME resource for the assigned specialty coding area, handling complex/escalated cases.
• Act as primary contact for physician-facing coding queries and drive accurate code assignment.
• Identify documentation gaps and coordinate with providers to resolve them promptly.
• Collaborate with CDI, Compliance, and Revenue Integrity teams on documentation improvements.
• Provide coding guidance and QA feedback to offshore and junior staff.
• Support denial and audit responses, including root-cause analysis.
• Stay current on CPT, HCPCS, ICD-10 updates, NCCI edits, and payer policies.
• Maintain productivity and quality standards for escalated case reviews.

Skills

Physician communication

Critical thinking

EHR proficiency

Independent work

Regulatory compliance

Education

Bachelor’s degree in Health Information Management

Tools

Epic

Job description

Healthrise is seeking a Coding Subject Matter Expert (SME) to act as an escalation-level coding resource across PB/ASC, Pathology/Radiology, or Primary Care specialties. This role collaborates with physicians to ensure accurate CPT/HCPCS/ICD-10 coding and keeps claims compliant, while mentoring junior staff and supporting audits.

The SME will navigate complex documentation questions, apply payer-specific policies, and stay updated on coding guidelines, with the flexibility to travel to client