Coding Specialist

JOB REQUIREMENTS: (Senior) Coding Specialist Job Locations US-WI-MadisonID 2026-2325 Category Claims Type Regular Full-Time Overview We'reseeking a skilled coding professional to support accurate, compliant,and high-quality claims processing across Quartz. This role may befilled at the Coding Specialist or Senior Coding Specialist level,depending on experience.You'll play a key role in applying regulatorycoding guidance, resolving complex claims and appeals, analyzing billingtrends, and collaborating across teams to strengthen payment integrityand reimbursement accuracy. This position offers hands-on work forexperienced coders as well as expanded leadership and subject-matterexpertise opportunities for senior-level professionals. Benefits:Collaborate with a team that respects and values your coding expertiseAccess professional development opportunities to support your long-termgrowth Starting pay range based upon skills and experience: $50,900 to$69,200 + robust benefits package Responsibilities Review and applyregulatory coding guidelines to ensure accurate and compliant claimsprocessing Investigate and resolve coding and claims issues, escalatingcomplex matters as appropriate Review, edit, and adjudicate pended ordenied claims in HealthLink (Epic) using Claim Edit Software (CES),regulatory guidance, and internal policies Research and resolvecoding-related appeals by reviewing medical documentation andcollaborating with Medical Directors, Pharmacy, and Medical ManagementAnalyze billing and coding data to identify trends, outliers, andpotential high-risk billing practices Conduct data analysis andreporting to support claim edits, denial trends, and leadership insightsRespond to coding-related inquiries from providers, members, andinternal teams through ServiceNow and CRM platforms Develop and delivercoding education and training for providers, leadership, and internalteams Collaborate with cross-functional teams-including PaymentIntegrity, Medical Management, SIU, Contracting, Benefits, CustomerSuccess, Marketing, and Provider Reimbursement Configuration-to ensurecoding compliance Stay current on industry trends, regulatory updates,and coding best practices Additional Responsibilities for Senior-LevelCandidates Lead the implementation and oversight of regulatory codingguidelines and complex coding initiatives Serve as a subject matterexpert (SME) for high-risk or complex coding scenarios Research,validate, and optimize claim edit logic, business rules, and systemconfigurations; test outcomes and guide improvements Partner with theSpecial Investigation Unit (SIU) to identify, investigate, and addressaberrant billing practices and patterns Lead or significantly contributeto... For full info follow application link. Equal Opportunity Employerof Minorities, Females, Protected Veterans, and Individual withDisabilities APPLICATION INSTRUCTIONS: Apply Online:ipc.us/t/73DAB83695A54A5B

Created: 2026-02-09