Remote Medical Coding Specialist – Prior Authorization

Integra Partners; United States; On-site; USD 58,500 - 71,500; Full time

Benefits offered by this job

Competitive compensation and annualBON

401(k) with company match

Company-paid life insurance

Health, Vision, and Dental benefits

Paid Time Off (PTO) & Parental Leave

Sick Time & Holidays

Quarterly company events

Career development opportunities

Job summary

Integra Partners is seeking a Medical Coding Specialist to support Utilization Management and prior authorization initiatives. You will research HCPCS, CPT, and ICD-10 guidance and apply it across Medicare, Medicaid, Commercial, and Marketplace products.

You will partner with clinical, operational, provider relations, credentialing, compliance, and business development teams to ensure accurate, compliant coding and timely deliverables.

Qualifications

• Minimum of 3 years medical coding experience.
• Experience with HCPCS, CPT, and ICD-10 coding.
• Knowledge of prior authorization processes and payer requirements.
• Ability to review CMS guidance and payer policies and ensure compliant coding.

Responsibilities

• Provide coding expertise to support utilization management, health plan implementations, and prior authorization program development.
• Develop and maintain Prior Authorization code lists and reference materials.
• Conduct quality review of coding deliverables for accuracy and completeness.
• Research unfamiliar coding scenarios and resolve questions with stakeholders.
• Collaborate with clinical, operational, compliance, and business teams on coding initiatives.
• Contribute to education materials and audits to support best practices.

Skills

HCPCS/CPT/ICD-10 coding

Prior Authorization coding

Detail-oriented

Research & problem solving

Cross-functional collaboration

Education

CPC/CCS/RHIT or equivalent

High school diploma or equivalent

Associate's or Bachelor's in HIM/Healthcare admin

Job description

Integra Partners is seeking a Medical Coding Specialist to support Utilization Management and prior authorization initiatives. You will research HCPCS, CPT, and ICD-10 guidance and apply it across Medicare, Medicaid, Commercial, and Marketplace products.

You will partner with clinical, operational, provider relations, credentialing, compliance, and business development teams to ensure accurate, compliant coding and timely deliverables.