# Healthcare Coding Expert (certified professional coder)

**Company**: GDIT
**Work arrangement**: remote
**Experience**: senior
**Job type**: full-time
**Salary**: $77,775 - $105,225
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://gdit.wd5.myworkdayjobs.com/en-US/External_Career_Site/job/Any-Location--Remote/Healthcare-Coding-Expert--certified-professional-coder-_RQ230138-1?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/jobs/job_40d41006-87b

## Description

GDIT's Federal Health Division is hiring a Healthcare Coding Expert to support the Centers for Medicare and Medicaid (CMS). You will be part of a 50-person team supporting the Trusted Third Party (TTP) which was established in 2012 to reduce fraud, waste and abuse in healthcare data.

**Key Responsibilities:**

- Perform analytical tasks to identify fraud, waste, and abuse referrals and leads from HFPP Analytics

- Collaborate on the development of HFPP analytic reports

- Drive outcome metrics related to fraud, waste, and abuse referrals and leads shared with Partners

- Review and analyze medical claims to determine accuracy, completeness and compliance with insurance policies, coding guidelines and reimbursement criteria

- Identify fraud, waste, and abuse schemes and conduct research and investigation of insurance policies, coding guidelines and reimbursement criteria

- Participate in quality assurance initiatives to ensure deliverable adherence to regulatory requirements, medical and company policies and industry standards

- Evaluate and respond to analytic output questions from internal and external parties

- Coach and provide guidance to less experienced professionals

**Requirements:**

- Bachelor's degree or equivalent year of work experience

- 8+ years' experience in healthcare claims analysis

- Certified Professional Coder (CPC) through the American Academy of Professional Coders (AAPC) or Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA)

- Expertise in medical terminology and all healthcare coding (e.g., ICD-10, CPT, HCPCS)

- Experience in program integrity and healthcare fraud, waste, and abuse activities

- Extensive knowledge of insurance regulations, reimbursement methodologies and healthcare compliance requirements

- Strong oral and written communication skills

- Expert level knowledge of Microsoft Office suite

- Experience with Tableau, Amazon WorkSpaces, Jira, and Confluence

- Working knowledge of HIPAA privacy and security rules

**Preferred Qualifications:**

- Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI) designation

**Benefits:**

- Medical plan options

- Dental plan options

- Vision plan

- 401(k) plan

- Paid time off plans

- Holidays

- Paid parental, military, bereavement and jury duty leave

- Short and long-term disability benefits

- Life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance

## Skills

### Required
- Claims Data
- Data Analysis
- Microsoft Excel
- Policy Analysis
- Strategic Objectives
- Tableau
- Amazon WorkSpaces
- Jira
- Confluence
- HIPAA
- ICD-10
- CPT
- HCPCS

### Nice to have
- Certified Fraud Examiner (CFE)
- Accredited Healthcare Fraud Investigator (AHFI)

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Source: [Apply at gdit.wd5.myworkdayjobs.com](https://gdit.wd5.myworkdayjobs.com/en-US/External_Career_Site/job/Any-Location--Remote/Healthcare-Coding-Expert--certified-professional-coder-_RQ230138-1?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)