Job Description
Pinnacle Method Consulting's mission is to help job seekers reach their career peak by accessing top-tier opportunities. We are not a staffing firm or agency. Pinnacle Method does not hire for these roles—we systematically source and verify them from premier employers. Employer Industry: Healthcare Consulting Why Consider This Job Opportunity Opportunity for career advancement and growth within the organization Engage in meaningful work that impacts healthcare coding and policy Work remotely, providing flexibility in your work environment Collaborative and supportive team atmosphere Involvement in agency projects and initiatives requiring subject matter expertise What To Expect (Job Responsibilities) Assist with the maintenance of CPT/HCPCS and ICD-10 codes Collaborate with internal teams to determine the scope of code changes and ensure timely completion Serve as an approver in the code change/update process following CMS updates Lead meetings with agency personnel, stakeholders, and process owners Research and maintain business rules, requirements, and models for documentation and training What Is Required (Qualifications) Minimum of 5 years' experience in healthcare insurance, medical review, program integrity, or appeals Minimum of 5 years' experience working with IT developers/programmers in a payer environment Minimum of 5 years' experience in medical coding within a payer environment Minimum of 3 years' clinical experience in a healthcare setting with strong assessment and critical thinking skills Bachelor's degree in Health Information, Healthcare Administration, or a related field; equivalent experience may be considered with a minimum of 3+ years of direct supervisory experience How To Stand Out (Preferred Qualifications) 5 years' experience in policy remediation 5 years' experience with medical claim processing systems Knowledge of Microsoft Office (Word, Excel, PowerPoint) and medical coding software programs #HealthcareConsulting #RemoteWork #CareerGrowth #MedicalCoding #HealthcarePolicy "We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer." #PinnacleMethodConsulting