Certified Medical Coding Specialist
Join Shift Technology as a Certified Medical Coding Specialist to enhance claim payment accuracy in a dynamic healthcare environment.
Posted by employer 7 months ago
First seen on Joblaze 1 hour ago
Last verified on the company career page 1 hour ago
What you'll build
- Assist in managing pre-pay and post-pay workflows
- Help define and validate claim edit logic
- Perform medical coding audits
- Support the customer appeals process
- Monitor payer policies and industry benchmarks
Must have
- 3+ years of experience in healthcare claims
- 2+ years as a certified medical coder
- Working knowledge of Medicare, Medicaid, and Commercial payer regulations
- Proficiency in auditing for coding accuracy
- Strong written and verbal communication skills
- Active medical coding credentials required
AI in the day-to-day
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Requirements
- Experience
- 3–5 years
- Education
- Bachelor's degree
Not disclosed in this posting: visa sponsorship.
Benefits
Joblaze summary
In this role, the Certified Medical Coding Specialist at Shift Technology focuses on enhancing claim payment accuracy through the management of pre-pay and post-pay workflows, including audits and validation of coding logic. The position requires a solid foundation in medical coding, with proficiency in ICD, CPT, and HCPCS codes, along with experience in healthcare claims and payment integrity. Ideal candidates will have at least three years of relevant experience and possess active medical coding credentials. The role involves collaboration with cross-functional teams to ensure the effectiveness of coding rules and policies.
Joblaze insights
- Listed today — first seen on Joblaze October 27, 2026. Last confirmed on Shift Technology's careers page October 27, 2026.
- Salary band is below the typical range for comparable tech roles (median ~$129,200).
- Starts above 4% of 1383 comparable mid other roles in United States we track (median $105,000 across 185 companies).
Quick facts
- Is the Certified Medical Coding Specialist role remote?
- It's hybrid — Shift Technology expects some on-site time in Boston, Massachusetts, United States.
- What's the salary range?
- Shift Technology lists $65,000–$95,000 for this role.
- How much experience is required?
- 3–5 years of relevant experience for this Certified Medical Coding Specialist role.
- Where is the role based?
- Shift Technology is hiring for this position in Boston, Massachusetts, United States.
- What seniority level is this role?
- Shift Technology targets mid-level candidates for this position.
- Is this full-time or contract?
- Full-time for this Certified Medical Coding Specialist role at Shift Technology.
From the original posting
Shift delivers AI agents that transform insurers' most critical work. By combining deep industry expertise and unmatched data resources, Shift provides proven results that have earned the trust of hundreds of the world's leading insurers. Our insurance-grade AI is accurate, explainable, and secure—empowering human experts to move with unmatched speed, total confidence, and a renewed focus on the people they serve.
Learn more at www.shift-technology.com
As part of our US Healthcare Payment Integrity and Customer Success organization, you will use your technical and clinical coding knowledge to help implement and support solutions that improve claim payment accuracy. Working closely with senior specialists, product, and technical teams, you will help validate edit logic, assist with audits, and identify opportunities to reduce waste and recover overpayments for our customers.
What you’ll do
- Support Claim Accuracy: Assist in managing pre-pay and post-pay workflows, including claim editing and recovery processes.
- Operationalize Logic: Help define and validate claim edit logic and payment integrity rules to ensure they are functioning correctly for customers.
- Conduct Focused Audits: Perform medical coding audits (inpatient, outpatient, professional) by validating ICD, CPT, HCPCS, and DRG codes under the guidance of senior staff.
- Assist with Reviews: Support the customer appeals process by reviewing billed services and assessing their alignment with policies and coding guidelines.
- Policy Research: Monitor payer policies and industry benchmarks to identify potential gaps in the current edit library and suggest improvements.
- Cross-Functional Collaboration: Partner with Product and Engineering teams to assist in testing, troubleshooting, and User Acceptance Testing (UAT) for new and updated rules.
- Documentation: Maintain clear documentation of audit findings and project progress for internal and external stakeholders.
What you bring
- 3+ years of experience in healthcare claims, provider billing, or health plan payment integrity.
- 2+ years as a certified medical coder in a payer, provider, or RCM environment.
- Solid Foundation: Working knowledge of Medicare, Medicaid, and Commercial payer regulations.
- Attention to Detail: Proficiency in auditing for coding accuracy (ICD, CPT, HCPCS, modifiers).
- Analytical Mindset: Ability to review data and identify trends or inconsistencies that impact claim accuracy.
- Communication Skills: Strong written and verbal skills; ability to explain technical coding findings clearly to team members.
- Adaptability: Ready to learn and grow in a fast-paced environment while managing multiple tasks effectively.
Qualifications and core requirements
- Education: Bachelor’s degree in Healthcare Administration, Business, or a related field (or equivalent experience).
- Certification: Active medical coding credentials required (CPC, CCS, or CCA).
The range listed is for base compensation. Your actual base salary will vary based on factors including location and individual qualifications objectively assessed during the interview process.
In addition to base salary, your total rewards package will include additional components such as incentive pay and benefits. If you're interviewing for this role, speak with your Talent Acquisition Partner to learn more about the specific details for this position.
To support our permanent, full time employees at every stage of their careers and lives, we provide a competitive total rewards and benefits package. Here are the global benefits we’d like to highlight:
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