[Hiring] Medical Coding Specialist @Sanderson Firm

Role Description

The Medicare Coding Specialist is responsible for researching, disputing, and finalizing potential financial reimbursement obligations for our clients. This role requires interaction not only with our clients, but with Medicare recovery contractors, Medicare Advantage Plans and their subrogation contractors, Part D Prescription Drug plans and the Department of Treasury. This position requires:

• An ability to understand complex and varying recovery processes
• A high level of productivity in a task-based/process-driven environment
• Exceptional analytical skills and attention to detail
• Excellent written and verbal communication skills

JOB RESPONSIBILITIES:

• Performs eligibility verifications for Medicare, Medicare Advantage, and Part D plans.
• Verifies Social Security Disability (SSD) entitlement.
• Conducts initial research across Medicare benefit plans to determine the existence of conditional payments or lien obligations.
• Reviews and analyzes correspondence from Medicare benefit plans to assess the accuracy of recovery actions.
• Communicates with client partners to validate claim information and identify opportunities for dispute or lien reduction.
• Applies complex medical and legal reasoning to support dispute strategies.
• Prepares and submits comprehensive disputes and appeals to the appropriate Medicare entities.
• Ensures timely and efficient follow-up on all cases to meet established turnaround times.
• Maintains regular communication with management regarding the status of verifications, disputes, appeals, and related services, and identifies when additional support is needed.
• Adheres to all company policies, including those related to safety, confidentiality, and organizational standards.
• Performs additional duties as assigned by supervisors.

Qualifications

• Associate degree preferred, along with 1–3 years of relevant experience in a customer service and/or administrative role.
• Demonstrates strong customer service skills.
• Works remotely in a productive and efficient manner.
• Proficient in multiple software programs, including but not limited to Microsoft Word, Outlook, and Excel.
• Exhibits strong communication skills, including conveying information accurately, listening effectively, and asking clarifying questions when needed.
• Follows instructions and responds appropriately to management direction.
• Possesses excellent command of the English language, including grammar, punctuation, and style.
• Works independently while effectively prioritizing tasks and managing time.
• Maintains focus and multitasks effectively in a fast-paced environment.
• Maintains confidentiality and handles sensitive information with discretion.
• Contributes to and promotes a positive, team-oriented environment.
• Performs effectively under pressure and in stressful situations.
• Adapts to change, delays, and unexpected events.
• Demonstrates reliability and consistently adheres to company attendance policies.

Benefits

• 100% Employer-Paid Medical Insurance options for employees
• Dental & Vision Coverage
• 401(k) with Company Match
• Company-Paid Life Insurance
• Optional Short Term Disability, Accident Insurance and more
• Paid Time Off & Holidays
• Supportive and team-oriented culture