Health Services Coding Analyst, CPC Required

Wellmark Blue Cross and Blue Shield

Health Services Coding Analyst at Wellmark providing clinical leadership in medical policy analysis and serving as a liaison for complex claims processing systems. Requires CPC certification and experience in healthcare coding.

Posted 6/6/2026full-timeRemote • South Dakota • 🇺🇸 United StatesSeniorLeadWebsite

About the role

Key responsibilities & impact

Provide clinical leadership and subject-matter expertise to support the analysis, configuration, and administration of complex medical policy content within claims processing systems, including Plan General Exclusion (PGE) rules and FACETS table maintenance.
Ensure the accurate implementation of medical policies, review criteria, and authorization requirements, while maintaining the integrity of system infrastructure and serving as a key liaison between business and technical teams.
Research and analyze system and business issues, develop high-level requirements, test and implement solutions, and audit and document outcomes.
Mentor and train Coding Specialists, and provide policy-related training and support to operational partners such as customer and provider services.

Requirements

What you’ll need

Associate degree or direct and applicable work experience preferred.
Certified Professional Coder (CPC) required.
Clinical background which may include either formal education or training in a clinical or health-related discipline (such as nursing, medical assisting, surgical technology, health information management, or a related field) and/or direct work experience in a clinical or healthcare setting.
7+ years’ or related health care experience in provider payment, claims, medical coding, or similar.
Demonstrated expertise and knowledge of medical coding and terminology.
Demonstrated strong attention to detail with the ability to multitask.
Strong interpersonal skills including clear and concise written and verbal communication.
Inquisitive nature, enthusiastic about developing and enacting new processes.
Strong workflow management skills with sense of ownership, drive and initiative to continuously improve outcomes.
Ability to communicate concepts clearly and concisely to individuals and groups and motivate others to achieve success with an eye toward promoting a culture of collegiality and excellence.
Demonstrated ability to obtain relevant information by relating and comparing data from different sources.
Proficiency in Microsoft Office applications including experience with spreadsheets, process mapping, presentation and word processing.
Ability to adhere to quality and production metrics.
Some experience with and continued interest in coaching and mentoring others.
Demonstrated ability to consistently meet department work schedule.

Benefits

Comp & perks

Employees can work remotely

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

medical codingmedical terminologyclaims processingPlan General Exclusion rulesFACETS table maintenancehigh-level requirements developmentsolution testing and implementationaudit and documentation

Soft Skills

attention to detailmultitaskinginterpersonal skillswritten communicationverbal communicationworkflow managementownershipinitiativecoachingmentoring

Certifications

Certified Professional Coder (CPC)