(Senior) Coding Compliance Specialist

We’reseeking a skilled coding professional to supportaccurate, compliant, and high-quality claims processing across Quartz. This role may be filledattheCoding Compliance Specialist orSenior Coding Compliance Specialist level,depending on experience.You’llplay a key role in applying regulatory coding guidance, resolving complex claims and appeals, analyzing billing trends, and collaborating across teams to strengthen payment integrity and reimbursement accuracy.This position offers hands-on work for experienced coders as well as expanded leadership and subject-matterexpertiseopportunities for senior-level professionals.Benefits:Collaborate with a team that respects and values your codingexpertiseAccessprofessional development opportunitiesto support your long-term growthStarting pay range based upon skills and experience:$50,900to $69,200+ robust benefits packageReview and apply regulatory coding guidelines to ensureaccurateand compliant claims processingInvestigate and resolve coding and claims issues, escalating complex matters as appropriateReview, edit, andadjudicatepended or denied claims in HealthLink (Epic) using Claim Edit Software (CES), regulatory guidance, and internal policiesResearch and resolve coding-related appeals by reviewing medical documentation and collaborating with Medical Directors, Pharmacy, and Medical ManagementAnalyze billing and coding data toidentifytrends, outliers, and potential high-risk billing practicesConduct data analysis and reporting to support claim edits, denial trends, and leadership insightsRespond to coding-related inquiries from providers, members, and internal teams through ServiceNow and CRM platformsDevelop and deliver coding education and training for providers, leadership, and internal teamsCollaborate with cross-functional teams—including Payment Integrity, Medical Management, SIU, Contracting, Benefits, Customer Success, Marketing, and Provider Reimbursement Configuration—to ensure coding complianceStay current on industry trends, regulatory updates, and coding best practicesAdditional Responsibilities for Senior-Level CandidatesLead the implementation and oversight of regulatory coding guidelines and complex coding initiativesServe as a subject matter expert (SME) for high-risk or complex coding scenariosResearch,validate, andoptimizeclaim edit logic, business rules, and system configurations; test outcomes and guide improvementsPartner with the Special Investigation Unit (SIU) toidentify, investigate, and address aberrant billing practices and patternsLead or significantly contribute to coding policy, procedure, and claim edit strategy developmentDrive strategy for coding education, provider communication, and internal training initiativesMentor and support mid-level team members and provide guidance on complex coding decisionsCoding Specialist:High School Equivalency with 6 years of Medical Coding experience OrAssociate's degree with 3 years of Medical Coding experienceCompletion of a Medical Coding ProgramCertifications in CPC, COC, RHIT, RHIA, CCA, and/or CCSSenior Coding Specialist:Associate’s degree with 5 years of Medical Coding experience OrHigh School Equivalency with 8 years of Medical Coding experienceCompletion of a Medical Coding ProgramCertifications in CPC, COC, RHIT, RHIA, CCA, and/or CCSHardware and equipment will be provided by the company, but candidates must have access to high-speed, non-satellite Internet to successfully work from home. We offer an excellent benefit and compensation package, opportunity for career advancement and a professional culture built on the foundations of Respect, Responsibility, Resourcefulness and Relationships. To support a safe work environment, all employment offers are contingent upon successful completion of a pre-employment criminal background check.Quartz values and embraces diversity and is proud to be an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity or expression, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified person with disability.

Created: 2026-02-16