FREE ACCESS
5,000–10,000 jobs/day
See all jobs on JobTailor
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
About the role
Key responsibilities & impact- Serve as the primary clinical coding advisor for AI product teams, providing guidance on ICD-10-CM/PCS, CPT/E&M, and DRG/inpatient coding rules, conventions, and edge cases.
- Interpret and apply CMS guidelines, LCD/NCD policies, AHA Coding Clinic guidance, and payer-specific policies to AI model training and validation activities.
- Partner with Legal and Compliance teams to ensure coding logic adheres to applicable federal and state regulations, including HIPAA and CMS standards.
- Drive cross-functional alignment on coding standards and AI solution design.
- Collaborate with AI engineers and data scientists to define coding logic, decision trees, and clinical criteria used in AI model development and prompt engineering.
Requirements
What you’ll need- 7+ years of hands-on clinical coding experience in a U.S. healthcare setting, with demonstrated expertise in ICD-10-CM/PCS, CPT/E&M, and DRG/inpatient coding.
- Active credential from AAPC or AHIMA (CPC, CCS, RHIA, RHIT, or equivalent)
- Strong working knowledge of CMS reimbursement methodologies, payer prior authorization processes, and claims adjudication and adjustment rules.
- Familiarity with healthcare data standards including ICD-10, CPT, HCPCS, NPI, and claims data formats (837P/837I)
- Experience reviewing medical records, interpreting clinical documentation, and applying coding guidelines to complex patient scenarios.
- Demonstrated ability to communicate clinical concepts clearly to non-clinical stakeholders including engineers, product managers, and business analysts.
Benefits
Comp & perks- Health insurance
- Training and development opportunities
- Flexible working arrangements
- Work-life balance
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
ICD-10-CMICD-10-PCSCPTE&MDRG codingclinical codingCMS reimbursement methodologiesclaims adjudicationhealthcare data standardsmedical record review
Soft Skills
communicationcollaborationcross-functional alignmentguidanceinterpretationproblem-solvingstakeholder engagementclinical concept explanation
Certifications
CPCCCSRHIARHITAAPC credentialAHIMA credential