We are looking for a skilled Clinical Policy Coding Administrator to join our team on a contract basis. This position is based in Mountlake Terrace, Washington, and offers an excellent opportunity to contribute to the health insurance industry. The selected candidate will play a key role in analyzing medical policies, ensuring accurate coding, and supporting cross-functional collaboration to enhance policy implementation and claims processing. Responsibilities: • Analyze and interpret medical policies to identify and update accurate procedure and diagnosis codes. • Collaborate with cross-functional teams to ensure seamless implementation of medical policies and utilization management guidelines. • Provide coding expertise to support decision-making processes related to claims, reimbursement, and product configuration. • Conduct thorough research and data analysis to evaluate the effectiveness of medical policy implementation. • Facilitate meetings and discussions with stakeholders to address coding edits and mitigate downstream impacts. • Ensure coding updates align with medical necessity and regulatory requirements. • Act as a subject matter expert in coding-related matters for various departments. • Address cross-functional requests with detailed assessments to enhance consistency in claims processing. • Support the development of medical policies by providing accurate coding recommendations. • Maintain compliance with industry standards and company-specific coding practices.

• Certification as a skilled coder with relevant experience in the health insurance industry. • Familiarity with FACETs claims system and other healthcare reimbursement platforms. • Strong analytical skills with the ability to evaluate and interpret medical policies. • Proven ability to collaborate effectively across multiple departments. • Knowledge of utilization management guidelines and medical necessity coding standards. • Excellent communication skills to facilitate discussions and provide coding expertise. • Experience in claims processing, reimbursement, and product configuration. • Ability to work independently and manage multiple priorities in a remote work environment.

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Mountlake Terrace, WA
remote
Temporary
40.00 - 50.00 USD / Hourly
We are looking for a skilled Clinical Policy Coding Administrator to join our team on a contract basis. This position is based in Mountlake Terrace, Washington, and offers an excellent opportunity to contribute to the health insurance industry. The selected candidate will play a key role in analyzing medical policies, ensuring accurate coding, and supporting cross-functional collaboration to enhance policy implementation and claims processing. Responsibilities: • Analyze and interpret medical policies to identify and update accurate procedure and diagnosis codes. • Collaborate with cross-functional teams to ensure seamless implementation of medical policies and utilization management guidelines. • Provide coding expertise to support decision-making processes related to claims, reimbursement, and product configuration. • Conduct thorough research and data analysis to evaluate the effectiveness of medical policy implementation. • Facilitate meetings and discussions with stakeholders to address coding edits and mitigate downstream impacts. • Ensure coding updates align with medical necessity and regulatory requirements. • Act as a subject matter expert in coding-related matters for various departments. • Address cross-functional requests with detailed assessments to enhance consistency in claims processing. • Support the development of medical policies by providing accurate coding recommendations. • Maintain compliance with industry standards and company-specific coding practices.
2025-11-13T00:04:07Z

Cw Clinical Policy Coding Administrator Job in Mountlake Terrace | Robert Half