Medical Coding Specialist

About Judi Health

Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.

At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. To learn more, visit www.judi.health.

Location: Hybrid (Local to Charlotte, NC; Denver, CO; or New York, NY area)

Position Overview

We are seeking a highly motivated Medical Coding Specialist to support the accurate configuration, testing, and maintenance of medical claims processing rules within our platform, Judi**®**. This role requires deep knowledge of medical coding, health plan operations, and claims adjudication, as well as the ability to translate client requirements into scalable system configurations. The ideal candidate is detail-oriented, adaptable, and passionate about leveraging technology to improve healthcare administration.

Key Responsibilities

• Stay current on coding and coverage guidelines from organizations such as CMS, AMA, AAPC, USPSTF, and other regulatory bodies.
• Utilize CPT, HCPCS, ICD-10, revenue, bill type, place of service, taxonomy, specialty, and related code sets to configure claims processing logic for commercial health plans.
• Configure, test, and maintain coding rules using internal coding and testing tools.
• Translate client requirements into accurate and timely system configurations.
• Research and resolve coding-related questions and escalations from claims processors, Customer Care, Account Management, and other stakeholders.
• Conduct regular claims reviews and audits to ensure coding accuracy, consistency, and compliance.
• Partner closely with Implementation, Benefit Operations, Product, and Technology teams to support new client implementations and platform enhancements.
• Contribute to continuous improvement initiatives that enhance claims processing accuracy and operational efficiency.
• Creates and maintains documentation, job aids, and reporting to support operational effectiveness and compliance.
• Support regulatory audits, quality improvement initiatives, and RFI/RFP responses as needed.