About the role
What will you do at Judi Health?
<div class="content-intro"><h2><strong>About Judi Health</strong></h2><p>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 Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single,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.<br><br>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 <span><a href="http://www.judi.health" target="_blank">www.judi.health</a></span>.</p></div><p><strong><u>Location:</u></strong> Hybrid (Local to Charlotte, NC; Denver, CO; or New York, NY area)</p><p><strong><u>Position Overview</u></strong></p><p>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<strong>®</strong>.
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.</p><p><strong><u>Key Responsibilities</u></strong></p><ul><li>Stay current on coding and coverage guidelines from organizations such as CMS, AMA, AAPC, USPSTF, and other regulatory bodies.</li><li>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.</li><li>Configure, test, and maintain coding rules using internal coding and testing tools.</li><li>Translate client requirements into accurate and timely system configurations.</li><li>Research and resolve coding-related questions and escalations from claims processors, Customer Care, Account Management, and other stakeholders.</li><li>Conduct regular claims reviews and audits to ensure coding accuracy, consistency, and compliance.</li><li>Partner closely with Implementation, Benefit Operations, Product, and Technology teams to support new client implementations and platform enhancements.</li><li>Contribute to continuous improvement initiatives that enhance claims processing accuracy and operational efficiency.</li><li>Creates and maintains documentation, job aids, and reporting to support operational effectiveness and compliance.</li><li>Support regulatory audits, quality improvement initiatives, and RFI/RFP responses as needed.</li><li>Develop and maintain departmental resources, including SharePoint sites and other team documentation.</li><li>Performs other duties and responsibilities as needed.</li></ul><p><strong> </strong><strong><u>Required Qualifications</u></strong></p><ul><li>Bachelor’s degree strongly preferred.</li><li>AAPC Medical Coding & Billing Certification (e.g., CPC) required.</li><li>5+ years of experience with a health plan, payer, or third-party administrator (TPA).</li><li>Strong understanding of CPT, ICD-10, HCPCS, Revenue Codes, Bill Type Codes, Place of Service Codes, and Taxonomy Codes.</li><li>Medicare and Medicaid experience preferred.</li><li>Demonstrated ability to learn and apply new technologies.</li><li>Proven track record of meeting deadlines and delivering high-quality results.</li><li>Excellent project management, time management, prioritization, and organizational skills.</li><li>Ability to manage multiple priorities in a fast-paced environment.</li><li>Proficiency with Microsoft Office Suite.</li><li>Strong verbal, written, presentation, and interpersonal communication skills.</li><li>Ability to collaborate effectively with cross-functional and virtual teams.</li></ul><p><strong><u>Preferred Qualifications</u></strong></p><ul><li>Analytical mindset with strong problem-solving skills and attention to detail.</li><li>Customer-focused approach with a passion for improving healthcare operations and driving process improvements.</li><li>Self-starter who can work independently, lead through subject matter expertise, and effectively collaborate across cross-functional teams.</li><li>Experience supporting regulatory audits, developing operational processes, and training or onboarding team members.</li></ul><p>This role offers the opportunity to play a key part in ensuring accurate claims processing, supporting client implementations, and helping drive innovation within a growing healthcare technology organization.</p><div class="content-pay-transparency"><div class="pay-input"><div class="title">New York, NY Salary Range</div><div class="pay-range"><span>$70,000</span><span class="divider">—</span><span>$85,000 USD</span></div></div><div class="pay-input"><div class="title">Denver, CO Salary Range</div><div class="pay-range"><span>$70,000</span><span class="divider">—</span><span>$85,000 USD</span></div></div><div class="pay-input"><div class="title">Charlotte, NC Salary Range</div><div class="pay-range"><span>$70,000</span><span class="divider">—</span><span>$85,000 USD</span></div></div></div><div class="content-conclusion"><p class="p1"><em>All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance.
This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.</em></p><p><em><span data-contrast="none">We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.</span></em><span data-ccp-props="{"134233117":false,"134233118":false,"335559738":0,"335559739":0}"> </span></p><p><span data-ccp-props="{"134233117":false,"134233118":false,"335559738":0,"335559739":0}">By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health.
More details about Judi Health's privacy practices can be found at<span class="Apple-converted-space"> </span><a href="https://www.judi.health/legal/privacy-policy" data-outlook-id="be5f7242-36ad-42be-9caf-fd585904c3c5">https://www.judi.health/legal/privacy-policy</a>.</span></p></div>
Make your next move
Build a shortlist and prepare
Identify the requirements you can demonstrate, then choose examples from your work to discuss with the hiring team.
- Build a focused shortlist before you applyCompare role requirements with your experience and give each application a clear reason.
- Platform engineering jobsCompare current openings and review what to look for in this role.
- Practice explaining your experience in an interviewRehearse your answers before meeting the hiring team.
Other roles to compare
Review the responsibilities and requirements before adding an opening to your shortlist.
Senior Infrastructure Engineer - Data Protection
USAA · Tampa, Florida, United States
Infrastructure Engineer I - Data Protection
USAA · Tampa, Florida, United States
Senior Machine Learning Engineer - ML Training Infrastructure
General Motors · Sunnyvale, California, United States
Neural Data Infrastructure Engineer
Blackrock Neurotech · Salt Lake City, Utah, United States
AI Infrastructure AI/ML Engineer (100 % remote) (m/f/d)
EWOR · Capon Bridge, West Virginia, United States
Senior Infrastructure Security Engineer
A-Gas · Rhome, Texas, United States
Role information can change. Prepin can help you prepare, but does not submit an application for this role.