Utility Management Nurse Coding Specialist

Utility Management Nurse Coding Specialist

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This range is provided by Mercor. Your actual pay will be based on your skills and experience—talk with your recruiter to learn more.

Base Pay Range

$45.00/hr - $75.00/hr

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About The Job

Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.

Position: Utility Management Nurse

Type: Contract / Part-time

Compensation: $45–$75/hour

Location: Remote/In person

Commitment: Flexible hours

Role Responsibilities

• Review and optimize insurance coding practices to ensure compliance and maximize reimbursement accuracy.
• Evaluate existing revenue management workflows and recommend improvements using AI‑driven documentation tools.
• Translate complex clinical notes into standardized coding formats (ICD‑10, CPT, HCPCS) aligned with payer policies.
• Assess coding accuracy against insurance guidelines and payer documentation requirements.
• Collaborate with engineering and product teams to refine AI models for medical coding and documentation.
• Ensure compliance with HIPAA, CMS, and payer‑specific coding regulations.

Qualifications

• Licensure: Registered Nurse (RN) or equivalent clinical background.
• Experience: Minimum 3–5 years in medical coding, clinical documentation improvement (CDI), or revenue cycle management.
• Certifications: CPC, CCS, or CRC certification preferred.
• Familiarity with hospital billing systems, payer policy interpretation, and coding audit procedures.
• Strong understanding of clinical documentation standards and payer logic.Comfortable working with EHR systems (Epic, Cerner, Meditech) and documentation review software.

• Experience within hospital revenue integrity teams or insurance utilization management.
• Exposure to AI‑powered healthcare documentation tools or automated coding systems.
• Ability to identify and flag edge cases or policy exceptions in automated workflows.
• Strong collaboration skills with cross‑functional teams.

Resources & Support

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Seniority Level

Not Applicable

Employment Type

Part‑time

Job Function

Health Care Provider

Industries

Software Development