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Medical Coding Consultant Jobs in Edison, NJ (NOW HIRING)

Stanford Health Care

Physician Educator III

Newark, NJ · On-site

$44.13 - $57.36/hr

This position provides training, consultation, review and feedback to clinicians on their medical service documentation and coding to ensure that SMP clinics receive appropriate reimbursement and ...

Infosys

Technology Consultant

Weehawken, NJ · On-site

... coding and integrate new features or updates into existing applications, with a focus on ... Medical/Dental/Vision/Life Insurance * Long-term/Short-term Disability * Health and Dependent Care ...

Infosys

Test Automation Consultant

Jersey City, NJ · On-site

... coding and integrate new features or updates into existing applications, with a focus on ... Medical/Dental/Vision/Life Insurance * Long-term/Short-term Disability * Health and Dependent Care ...

Infosys

Test Automation Consultant

Iselin, NJ · On-site

... coding and integrate new features or updates into existing applications, with a focus on ... Medical/Dental/Vision/Life Insurance * Long-term/Short-term Disability * Health and Dependent Care ...

Infosys

Test Automation Consultant

Weehawken, NJ · On-site

... coding and integrate new features or updates into existing applications, with a focus on ... Medical/Dental/Vision/Life Insurance * Long-term/Short-term Disability * Health and Dependent Care ...

Infosys

Test Automation Consultant

New York, NY · On-site

... coding and integrate new features or updates into existing applications, with a focus on ... Medical/Dental/Vision/Life Insurance * Long-term/Short-term Disability * Health and Dependent Care ...

Infosys

Automation Testing Consultant

Princeton, NJ · On-site

... coding and integrate new features or updates into existing applications, with a focus on ... Medical/Dental/Vision/Life Insurance * Long-term/Short-term Disability * Health and Dependent Care ...

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Medical Coding Consultant information

See Edison, NJ salary details

$32.1K

$153.4K

$413.1K

How much do medical coding consultant jobs pay per year?

As of Sep 1, 2026, the average yearly pay for medical coding consultant in Edison, NJ is $153,382.00, according to ZipRecruiter salary data. Most workers in this role earn between $100,900.00 and $187,900.00 per year, depending on experience, location, and employer.

What is a medical coding consultant?

A Medical Coding Consultant is a specialized professional who ensures accurate medical coding and compliance with healthcare regulations. They review patient records, assign appropriate codes for diagnoses and procedures, and provide guidance to healthcare providers on coding best practices. Their role helps optimize reimbursements, reduce claim denials, and maintain regulatory compliance. Additionally, they may conduct audits, train coding staff, and stay updated on industry changes.

What are the key skills and qualifications needed to thrive as a medical coding consultant?

To thrive as a Medical Coding Consultant, you need in-depth knowledge of medical terminology, anatomy, healthcare regulations, and coding systems, typically supported by certifications such as CPC or CCS. Familiarity with electronic health record (EHR) systems, encoder software, and official coding guidelines is essential. Attention to detail, analytical thinking, and effective communication help you navigate complex documentation and advise healthcare clients. These skills ensure accurate coding, regulatory compliance, and optimized reimbursement processes.

What are the most common challenges medical coding consultants face on the job?

Medical Coding Consultants often encounter challenges such as interpreting complex or incomplete medical records, staying updated on frequent changes to coding standards, and ensuring client compliance with evolving regulations. Consultants may also need to train or guide clinical staff, address coding discrepancies, and manage multiple healthcare projects simultaneously. While these hurdles can be demanding, they offer valuable opportunities to build expertise, take initiative, and become a trusted advisor within the healthcare sector. Collaboration with physicians, coders, and billing teams is also central to resolving these challenges efficiently.

What are popular job titles related to Medical Coding Consultant jobs in Edison, NJ?

For Medical Coding Consultant jobs in Edison, NJ, the most frequently searched job titles are:

What job categories do people searching Medical Coding Consultant jobs in Edison, NJ look for?

The top searched job categories for Medical Coding Consultant jobs in Edison, NJ are:

Medical Coding Consultant jobs near you
Infographic showing various Medical Coding Consultant job openings in Edison, NJ as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $153,382 per year, or $73.7 per hour.

Nurse Case Manager, Utilization Management

Manhattan, NY • On-site

1199SEIU Funds
Insurance Services • 501 - 1,000 employees
Learn more about 1199SEIU Fundsexternal

Full-time

Re-posted 21 days ago

Job description


Responsibilities
Use industry criteria, benefit plan design, clinical knowledge, and critical thinking to assess, plan and provide, ongoing coordination and management of service delivery through an integrated case management approach
Performs medical necessity review that includes concurrent, prospective, retrospective reviews and 1st level appeals, to ensure compliance with applicable criteria, medical policy, member eligibility, benefits and vendor contracts.
Apply Milliman Care Guidelines, internal Policies and Reference Guides to determine appropriateness of services/equipment that require Prior Authorization
Maintain accurate records of all patient/provider/vendor related interactions in designated medical management system
Apply clinical guidelines, provide recommendations and discuss cases with Medical Consultants
Meet timelines and quality standards related to Utilization Management
Maintain and submit reports and logs on reviewed activities as outlined by the UM program operational procedures,
Identify and participate in quality improvement activities as it relates to internal programs, processes studies and projects
Authorize vendor services using clinically proven criteria to make consistent care decisions
Maintain compliance with all state mandated regulations
Identify and problem solve issues with appropriate services to ensure positive member outcomes utilizing cost efficient covered services
Responsible for abiding by and supporting the care management programs in order to ensure quality and efficient clinical operations
Perform additional duties and projects as assigned by management


Qualifications
Bachelor's degree Valid New York State Registered Nurse (RN) required
Minimum three (3) years Medical/Surgical experience plus a minimum of two (2) years Utilization Management experience required
BSN and Certification in Case Management a plus
Proficient in application and use of industry standard Utilization Management criteria (Milliman Care Guidelines), Medicare and coverage guidelines, health claims processing, medical coding
Excellent verbal and written communication skills, problem-solving, clinical assessment, care planning skills, and independent decision-making capability
Computer and organizational skills required, ability to manage competing priorities, multi-task with results-oriented outcomes and work in a fast paced environment. Intermediate skills of Microsoft Office systems preferred.

Employment Type: Full time

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