Senior Medical Coding Specialist

In this role you will

• Audit behavioral health documentation and coding (ICD-10-CM and CPT) for accuracy, compliance, and completeness
• Deliver actionable feedback to providers through 1:1 remediation meetings, educating on coding and documentation guidelines (i.e., coding based on medical decision making (MDM) for outpatient Evaluation and Management services)
• Serve as a subject matter expert by answering coding-related questions to support internal teams and create processes
• Contribute to provider education efforts, including drafting content, identifying documentation gaps, and advising on clinical documentation standards
• Provide insights on coding trends, identify risk areas, and recommend improvements to tooling, product, and training
• Collaborate with cross-functional partners on initiatives and enhancements regarding billing code guardrails
• Stay current with evolving coding guidelines, payer rules, and industry standards through continuing education and independent learning

You’d be a great fit if

• Have a CPC certification (required) and 2+ years of experience in outpatient or professional services coding within a behavioral health setting
• Have the ability to balance supportive coaching and enforcing provider policies regarding payer standards and compliance regulations.
• Previously educated providers on medical decision making (MDM) for outpatient Evaluation and Management services
• Hold a CPMA certification (nice to have) or have strong auditing experience
• Possess a strong grasp of ICD-10, CPT, and HCPCS coding guidelines and the documentation requirements
• Communicate clearly and empathetically, especially when educating providers or discussing sensitive feedback
• Bring a high level of attention to detail and comfort working independently in a fast-paced, digital environment
• Are tech-savvy: you can navigate Google Workspace, Zoom, and EMR platforms—or you’re excited to learn
• Are energized by working cross-functionally and driving quality at scale in a tech-forward setting