Medical Coding Specialist Jobs
Medical Coding Specialist jobs are open across hospitals, physician practices, insurance companies, and health systems, from entry-level to senior and lead roles, with specializations in inpatient coding, outpatient coding, and risk adjustment. Find a role that fits from the openings below and apply directly.
Find JobsLooking for remote work? View remote medical coding specialist jobs →Overview
Showing 5 of 119+ Medical Coding Specialist jobs
Position Summary:
The Medical Coding Auditor conducts audits to provide investigative support related to potential fraud, waste, abuse and/or overpayment. Through pre and post payment medical records review and appeal records review, the Medical Coding Auditor ensures appropriate coding on claims paid and maintains compliance documentation of any fraud, waste or abuse identified based on coding guidelines, coverage policies and regulatory and contract requirements.
Qualifications:
- Medical Coder certification from accredited source (e.g. American Health Information Management Association, American Academy of Professional Coders or Practice Management Institute) required.
- Prior experience in Medicaid claims role and/or post payment medical coding auditor role preferred.
- Knowledge of Medicaid rules, claims processing, medical terminology and coding principles and practices.
- Knowledge of auditing, investigation, and research.
- Knowledge of word processing software, spreadsheet software, and internet software.
- Manage time efficiently and follow through on duties to completion
Essential Duties and Responsibilities:
- Maintains a caseload of audit reviews and a caseload of appeals reviews, ensuring movement and timely action taken. Documents time spent through software used.
- Performs pre and post payment medical record review audits of claims payments to identify potential fraud, waste, abuse and/or overpayment based on contract/regulatory requirements, coding guidelines, and coverage policies.
- Performs reviews of appeal records received based on contract/regulatory requirements, coding guidelines, and coverage policies, prepares review summary for presentation to the appeals committee, and presents appeal review to the appeals committee. Generates appeal committee determination notice, sends to provider, and tracks for response.
- Generates statistically valid random samples through software used. Generates audit notice with sample/attestation, sends to provider, and tracks for provider response.
- Monitors the CCP fax and CCP.SIU inboxes for receipt of medical records.
- Completes and maintains detailed documentation of audits including but not limited to coding guidelines reviewed, coverage policy documentation, decision methodology, and monetary discrepancies identified.
- Notifies the provider of audit findings, including but not limited to overpayment, education, and no issues identified.
- Responsible for reviewing audit and appeal records for potential fraud, waste or abuse, documenting any FWA findings for presentation to Manager, Compliance for further investigation.
- Documents all audit steps in the case in the software used.
- Prepares written reports or trending data related to findings and facilitates timely turnaround of audit results.
- Prepares written summaries of audit results for purposes of reporting potential fraud, waste, abuse and/or overpayment.
- Retrieves and compiles data across multiple information systems and provides needed information for internal and external customers in a timely manner.
- Identifies potential provider fraud through review of claims data, complaint referrals, and application of rules, healthcare coding practices, and fraud detection software.
- Reviews provider billing practices to investigate claims data and compliance with State and Federal laws.
- Analyzes provider data and identifies erroneous or questionable billing practices.
- Interprets state and federal policies, Florida Medicaid, Children’s Health Insurance Program, Marketplace, and contract requirements.
- Determines and calculates overpayment/underpayment, appropriately documents and participates in steps to remediate.
- Determines priorities and method of completing daily workload to ensure that all responsibilities are carried out in a timely manner.
- Performs all other duties as assigned.
This job description in no way states or implies that these are the only duties performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management.
Skills and Abilities:
- Written and verbal communication skills.
- Ability to organize and prioritize work with minimum supervision.
- Detail oriented.
- Ability to perform math calculations.
- Analytical and critical thinking skills.
- Ability to operate personal computer and general office equipment as necessary to complete essential functions, including using spreadsheets, word processing, database, email, internet, and other computer programs.
- Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
- Ability to write reports, business correspondence, and procedure manuals.
- Ability to effectively present information and respond to questions.
Work Schedule:
Community Care Plan is currently following a hybrid work schedule. The company reserves the right to change the work schedules based on the company needs.
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. A reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit, use hands, reach with hands and arms, and talk or hear. The employee is frequently required to stand, walk, and sit. The employee may occasionally be required to stoop, kneel, crouch or crawl. The employee may occasionally lift and/or move up to 15 pounds.
Work Environment:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job. The environment includes work inside/outside the office, travel to other offices, as well as domestic travel. A reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.
We are an equal opportunity employer who recruits, employs, trains, compensates and promotes regardless of age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique. We are committed to fostering, cultivating, and preserving a culture of diversity, equity, and inclusion.
Background Screening Notice:
In compliance with Florida law, candidates selected for this position must complete a Level 2 background screening through the Florida Care Provider Background Screening Clearinghouse.
The Clearinghouse is a statewide system managed by the Agency for Health Care Administration (AHCA) and is designed to help protect children, seniors, and other vulnerable populations while streamlining the screening process for employers and applicants.
Additional information is available at: https://info.flclearinghouse.com
Position Summary:
The Medical Coding Auditor conducts audits to provide investigative support related to potential fraud, waste, abuse and/or overpayment. Through pre and post payment medical records review and appeal records review, the Medical Coding Auditor ensures appropriate coding on claims paid and maintains compliance documentation of any fraud, waste or abuse identified based on coding guidelines, coverage policies and regulatory and contract requirements.
Qualifications:
- Medical Coder certification from accredited source (e.g. American Health Information Management Association, American Academy of Professional Coders or Practice Management Institute) required.
- Prior experience in Medicaid claims role and/or post payment medical coding auditor role preferred.
- Knowledge of Medicaid rules, claims processing, medical terminology and coding principles and practices.
- Knowledge of auditing, investigation, and research.
- Knowledge of word processing software, spreadsheet software, and internet software.
- Manage time efficiently and follow through on duties to completion
Essential Duties and Responsibilities:
- Maintains a caseload of audit reviews and a caseload of appeals reviews, ensuring movement and timely action taken. Documents time spent through software used.
- Performs pre and post payment medical record review audits of claims payments to identify potential fraud, waste, abuse and/or overpayment based on contract/regulatory requirements, coding guidelines, and coverage policies.
- Performs reviews of appeal records received based on contract/regulatory requirements, coding guidelines, and coverage policies, prepares review summary for presentation to the appeals committee, and presents appeal review to the appeals committee. Generates appeal committee determination notice, sends to provider, and tracks for response.
- Generates statistically valid random samples through software used. Generates audit notice with sample/attestation, sends to provider, and tracks for provider response.
- Monitors the CCP fax and CCP.SIU inboxes for receipt of medical records.
- Completes and maintains detailed documentation of audits including but not limited to coding guidelines reviewed, coverage policy documentation, decision methodology, and monetary discrepancies identified.
- Notifies the provider of audit findings, including but not limited to overpayment, education, and no issues identified.
- Responsible for reviewing audit and appeal records for potential fraud, waste or abuse, documenting any FWA findings for presentation to Manager, Compliance for further investigation.
- Documents all audit steps in the case in the software used.
- Prepares written reports or trending data related to findings and facilitates timely turnaround of audit results.
- Prepares written summaries of audit results for purposes of reporting potential fraud, waste, abuse and/or overpayment.
- Retrieves and compiles data across multiple information systems and provides needed information for internal and external customers in a timely manner.
- Identifies potential provider fraud through review of claims data, complaint referrals, and application of rules, healthcare coding practices, and fraud detection software.
- Reviews provider billing practices to investigate claims data and compliance with State and Federal laws.
- Analyzes provider data and identifies erroneous or questionable billing practices.
- Interprets state and federal policies, Florida Medicaid, Children’s Health Insurance Program, Marketplace, and contract requirements.
- Determines and calculates overpayment/underpayment, appropriately documents and participates in steps to remediate.
- Determines priorities and method of completing daily workload to ensure that all responsibilities are carried out in a timely manner.
- Performs all other duties as assigned.
This job description in no way states or implies that these are the only duties performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management.
Skills and Abilities:
- Written and verbal communication skills.
- Ability to organize and prioritize work with minimum supervision.
- Detail oriented.
- Ability to perform math calculations.
- Analytical and critical thinking skills.
- Ability to operate personal computer and general office equipment as necessary to complete essential functions, including using spreadsheets, word processing, database, email, internet, and other computer programs.
- Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
- Ability to write reports, business correspondence, and procedure manuals.
- Ability to effectively present information and respond to questions.
Work Schedule:
Community Care Plan is currently following a hybrid work schedule. The company reserves the right to change the work schedules based on the company needs.
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. A reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit, use hands, reach with hands and arms, and talk or hear. The employee is frequently required to stand, walk, and sit. The employee may occasionally be required to stoop, kneel, crouch or crawl. The employee may occasionally lift and/or move up to 15 pounds.
Work Environment:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job. The environment includes work inside/outside the office, travel to other offices, as well as domestic travel. A reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.
We are an equal opportunity employer who recruits, employs, trains, compensates and promotes regardless of age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique. We are committed to fostering, cultivating, and preserving a culture of diversity, equity, and inclusion.
Background Screening Notice:
In compliance with Florida law, candidates selected for this position must complete a Level 2 background screening through the Florida Care Provider Background Screening Clearinghouse.
The Clearinghouse is a statewide system managed by the Agency for Health Care Administration (AHCA) and is designed to help protect children, seniors, and other vulnerable populations while streamlining the screening process for employers and applicants.
Additional information is available at: https://info.flclearinghouse.com
Medical Coding Specialist Jobs by Experience Level
See All 119+ Medical Coding Specialist Jobs
Find roles that match your experience and apply in just a few clicks.
Find JobsMedical Coding Specialist Job Market
Who's Hiring
Top Industries Hiring
- Healthcare & Medical Services
- Education
- Hospitality & Tourism
- Non-Profit & Social Services
What Employers Look For
The qualifications that appear most often in medical coding specialist jobs.
- Active CPC, CCS, or equivalent AHIMA or AAPC certification required
- Proficiency in ICD-10-CM, ICD-10-PCS, and CPT coding systems
- Experience with encoder software such as 3M, Optum360, or TruCode
- Knowledge of medical terminology, anatomy, and pathophysiology
- Minimum one to three years of coding experience in a clinical or hospital setting
- Familiarity with payer-specific guidelines, LCD policies, and compliance standards
Tips for Your Medical Coding Specialist Job Search
List certifications prominently on your resume
Recruiters screening medical coding specialist resumes scan for CPC, CCS, or CPC-H credentials before reading anything else. Put your active certifications and their issuing body directly under your name, not buried in a skills section.
Tailor your resume to the care setting
A hospital system posting emphasizes inpatient DRG and ICD-10-CM/PCS experience, while a physician group wants outpatient CPT proficiency. Rewrite your summary and top bullet points to match the specific setting in each job description before you apply.
Filter openings by coding specialty not just job title
Search for terms like risk adjustment, HCC coding, or facility coding alongside your title. Many roles are posted under broader titles that bury the specialty, and filtering by these terms surfaces openings your competition misses.
Apply early to roles that fit
Migrate Mate lists medical coding specialist openings from across the United States in one place, so you can find roles that match and apply directly to each listing.
Prepare for a live coding audit in interviews
Many employers give a timed coding exercise during the interview using sample operative notes or clinic records. Practice assigning codes from scratch using only an encoder, not auto-suggest, so you can perform accurately under time pressure.
Negotiate remote work terms before accepting
Remote medical coding roles often come with productivity quotas measured in charts per hour and audit accuracy thresholds. Ask about those benchmarks explicitly before you sign, so you know exactly what the remote arrangement requires of you.
Medical Coding Specialist Jobs: Frequently Asked Questions
Which companies are hiring the most medical coding specialists?
The companies hiring the most medical coding specialists right now include UEI College, MedHQ, and Kaiser Permanente, with the largest share of openings in Texas, Florida, and California, based on current listings on Migrate Mate as of September 2026. Large hospital systems, national health information management firms, and insurance payers consistently post the highest volume of openings.
How many medical coding specialist jobs are remote?
About 65% of medical coding specialist openings are fully remote or hybrid as of September 2026, making it one of the more remote-accessible roles in healthcare. Outpatient coding, risk adjustment coding, and chronic care HCC work tend to have the highest share of fully remote positions compared to inpatient facility coding.
How do you become a medical coding specialist?
You typically complete a medical coding certificate or associate degree program that covers anatomy, medical terminology, and coding systems including ICD-10 and CPT. After completing your training, you sit for a certification exam through AAPC or AHIMA. Most entry-level roles require at least one active credential, and building experience through internships or practicum placements before the exam strengthens your application.
Can you get hired as a medical coding specialist with no experience?
Yes, entry-level medical coding specialist roles exist, but employers hiring without experience almost always require an active CPC or CCA certification as a substitute. Completing a practicum during your coding program, volunteering to code for a local clinic, or taking on remote auditing work on a contract basis gives you chart counts to cite on your resume, which is the most common barrier for new graduates.
What does the medical coding specialist interview process look like?
Most interviews begin with a phone screen focused on your certification status and coding background, followed by a technical interview where a compliance or HIM manager walks through your specialty experience. Many employers then assign a practical coding exercise using de-identified records. Final rounds typically involve a conversation with a department lead and a review of productivity expectations and accuracy benchmarks before an offer is extended.
Where can I find and apply to medical coding specialist jobs?
You can find and apply to medical coding specialist jobs on Migrate Mate, which lists current openings from across the United States. Find roles that match your specialty, certification, and preferred work setting, then apply directly to each listing that fits.
See All 119+ Medical Coding Specialist Jobs
Find roles that match your experience and apply in just a few clicks.
Find Jobs