Remote Healthcare Coding Specialist

Remote, USA Full-time Posted 2025-03-07

Remote Healthcare Coding Specialist (Utilization Management)

Pride Health is hiring Remote Healthcare Coding Specialist openings to support our Healthcare clients...

Job Details:
? Job Type: 6 month contract (project-based)
? Pay range: $30 - $35 per hour (Based on experience, credentialing, and location).
? Shift and Schedule: Should be flexible to work in the PST time zone.

Job Duties:
? Responsible for accurately coding medical, surgical, and diagnostic services and procedures, durable medical equipment, and ambulance services using ICD-10-CM, CPT, and HCPCS Level II classification systems to support Utilization Management
? Provide coding expertise to support pre-authorization, concurrent, and retrospective reviews
? Ensure coding practices comply with federal, state, and payer-specific regulations and guidelines
? Stay updated on changes in coding standards, utilization management guidelines, and reimbursement policies
? Work closely with the UM product team and clinical SME to clarify diagnoses and procedures, ensuring accurate coding
? Preferred: ability to analyze coding data to identify trends and patterns related to utilization and costs

Qualifications: ? Education: ? Associate or bachelor?s degree ? Certified Professional Coder ? Experience Required: ? Minimum of 2 years of experience in medical coding. ? Preferred: ? Experience in coding for various specialties such as inpatient, outpatient, emergency, or surgery preferred. ? Skills: ? Proficiency in ICD-10-CM, CPT, and HCPCS Level II coding. ? Strong knowledge of medical terminology, anatomy, and physiology. ? Excellent attention to detail and analytical skills. ? Ability to work independently and as part of a team. ? Effective communication and interpersonal skills. ? Proficiency in coding software

Benefits

Pride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.

Equal Opportunity Employer

As a certified minority-owned business, Pride Global and its affiliates - including Russell Tobin, Pride Health, and Pride Now - are committed to creating a diverse environment and are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics

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