Medical Coding Specialist

Sanderson Firm• Remote, US,

1d•$22 - $25•Remote

About The Position

The Medicare Coding Specialist researches, disputes, and finalizes potential financial reimbursement obligations for clients. The role involves interacting with clients, Medicare recovery contractors, Medicare Advantage Plans and their subrogation contractors, Part D Prescription Drug plans, and the Department of Treasury. It requires understanding complex and varying recovery processes, working productively in a task-based, process-driven environment, applying analytical skills and attention to detail, and communicating effectively in writing and verbally.

Requirements

1–3 years of relevant experience in a customer service and/or administrative role.
Strong customer service skills.
Ability to work remotely in a productive and efficient manner.
Proficiency with multiple software programs, including Microsoft Word, Outlook, and Excel.
Strong communication skills, including conveying information accurately, listening effectively, and asking clarifying questions when needed.
Ability to follow instructions and respond appropriately to management direction.
Excellent command of English, including grammar, punctuation, and style.
Ability to work independently, prioritize tasks, and manage time.
Ability to maintain focus and multitask effectively in a fast-paced environment.
Ability to maintain confidentiality and handle sensitive information with discretion.
Ability to contribute to and promote a positive, team-oriented environment.
Ability to perform effectively under pressure and in stressful situations.
Ability to adapt to change, delays, and unexpected events.
Reliability and consistent adherence to company attendance policies.

Nice To Haves

Associate degree preferred.

Responsibilities

Perform eligibility verifications for Medicare, Medicare Advantage, and Part D plans.
Verify Social Security Disability (SSD) entitlement.
Conduct initial research across Medicare benefit plans to determine whether conditional payments or lien obligations exist.
Review and analyze correspondence from Medicare benefit plans to assess the accuracy of recovery actions.
Communicate with client partners to validate claim information and identify opportunities for disputes or lien reduction.
Apply complex medical and legal reasoning to support dispute strategies.
Prepare and submit comprehensive disputes and appeals to appropriate Medicare entities.
Follow up on all cases in a timely and efficient manner to meet established turnaround times.
Keep management informed about the status of verifications, disputes, appeals, and related services, and identify when additional support is needed.
Adhere to company policies, including those related to safety, confidentiality, and organizational standards.
Perform additional duties as assigned by supervisors.