This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Vendor Medical Coding Analyst based in the United States.

This role sits at the intersection of clinical coding accuracy, vendor oversight, and claims integrity within a healthcare reimbursement environment. You will play a key part in ensuring that medical documentation, diagnostic codes, and procedural data accurately reflect services provided and comply with industry standards. The position focuses on improving payment accuracy, identifying root causes of claims issues, and strengthening vendor performance through data-driven insights. You will collaborate closely with internal teams and external partners to resolve complex coding and reimbursement challenges. The work directly supports financial accuracy, regulatory compliance, and operational efficiency across the claims lifecycle. This is a highly analytical and detail-oriented role where your expertise influences both cost integrity and process improvement.

Accountabilities

In this role, you will analyze medical records, coding practices, and vendor claims data to ensure accuracy, compliance, and alignment with established reimbursement and coding guidelines.

Review and audit medical documentation to validate diagnosis and procedure coding accuracy in vendor-submitted claims
Identify root causes of payment discrepancies and lead resolution efforts with vendors and internal stakeholders
Conduct medical record audits and assess claims impact to support accurate reimbursement outcomes
Develop and implement process improvement initiatives to address coding, billing, and operational gaps
Serve as a subject matter expert on coding guidelines, reimbursement methodologies, and claims interpretation
Create test scenarios and validation plans to ensure compliance with industry coding standards
Track issue resolution progress and ensure timely completion of corrective actions across teams
Collaborate cross-functionally to support regulatory compliance and vendor performance management

Requirements

This role requires strong expertise in medical coding, claims processing, and healthcare reimbursement systems, combined with analytical and communication skills to influence outcomes across teams and vendors.

Bachelor’s degree or equivalent relevant experience in lieu of degree
Certified Medical Coder (CPC, RHIT, or RHIA) required
Minimum 3 years of medical billing and coding experience
At least 3 years of claims payment or claims processing experience
Managed care experience preferred
Strong knowledge of ICD, CPT coding guidelines, medical terminology, and anatomy/physiology
Understanding of Medicare, Medicaid, and commercial reimbursement methodologies (APC, DRG, OPPS preferred)
Proficiency with claims systems and tools such as Facets, along with Microsoft Office applications
Strong analytical thinking, attention to detail, and ability to identify trends in complex data
Excellent written and verbal communication skills with the ability to engage across technical and operational teams
Ability to work independently while managing multiple priorities in a deadline-driven environment

Benefits

Competitive salary with performance-based bonus eligibility
Comprehensive medical, dental, and vision insurance coverage
Retirement savings plan with employer contribution options
Paid time off, holidays, and additional leave programs
Professional development and continuing education support
Flexible work environment depending on operational needs
Opportunity to work in a data-driven healthcare environment focused on process improvement and impact
Equipment and tools provided for remote or hybrid work arrangements

How Jobgether works:

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Why Apply Through Jobgether?

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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Vendor Medical Coding Analyst

Requirements

Benefits

Remote Healthcare Jobs