The successful RN candidate will review both medical (Medicare Part B/C) and pharmacy (Medicare Part D) appeals for Medicare/DSNP benefits, medical necessity, coding accuracy and medical policy ...
The successful RN candidate will review both medical (Medicare Part B/C) and pharmacy (Medicare Part D) appeals for Medicare/DSNP benefits, medical necessity, coding accuracy and medical policy ...
Job Title Medicare Appeals And Grievances Rn Senior Your Role The Medicare Appeals And Grievances ... Ensure proper procedure codes, diagnosis codes, drug names and dosages are reviewed for submitted ...
Job Title Medicare Appeals And Grievances Rn Senior Your Role The Medicare Appeals And Grievances ... Ensure proper procedure codes, diagnosis codes, drug names and dosages are reviewed for submitted ...
The successful RN candidate will review both medical (Medicare Part B/C) and pharmacy (Medicare Part D) appeals for Medicare/DSNP benefits, medical necessity, coding accuracy and medical policy ...
The successful RN candidate will review both medical (Medicare Part B/C) and pharmacy (Medicare Part D) appeals for Medicare/DSNP benefits, medical necessity, coding accuracy and medical policy ...
The successful RN candidate will review both medical (Medicare Part B/C) and pharmacy (Medicare Part D) appeals for Medicare/DSNP benefits, medical necessity, coding accuracy and medical policy ...
The successful RN candidate will review both medical (Medicare Part B/C) and pharmacy (Medicare Part D) appeals for Medicare/DSNP benefits, medical necessity, coding accuracy and medical policy ...
The successful RN candidate will review both medical (Medicare Part B/C) and pharmacy (Medicare Part D) appeals for Medicare/DSNP benefits, medical necessity, coding accuracy and medical policy ...
The successful RN candidate will review both medical (Medicare Part B/C) and pharmacy (Medicare Part D) appeals for Medicare/DSNP benefits, medical necessity, coding accuracy and medical policy ...
The successful RN candidate will review both medical (Medicare Part B/C) and pharmacy (Medicare Part D) appeals for Medicare/DSNP benefits, medical necessity, coding accuracy and medical policy ...
The successful RN candidate will review both medical (Medicare Part B/C) and pharmacy (Medicare Part D) appeals for Medicare/DSNP benefits, medical necessity, coding accuracy and medical policy ...
Job Title Medicare Appeals And Grievances Rn Senior Your Role The Medicare Appeals And Grievances ... Ensure proper procedure codes, diagnosis codes, drug names and dosages are reviewed for submitted ...
New
Job Title Medicare Appeals And Grievances Rn Senior Your Role The Medicare Appeals And Grievances ... Ensure proper procedure codes, diagnosis codes, drug names and dosages are reviewed for submitted ...
New
This is a part-time position focused on ensuring compliance with Medicare and DOJ guidelines, making payment determinations based on coverage and coding principles. Ideal candidates will possess ...
This is a part-time position focused on ensuring compliance with Medicare and DOJ guidelines, making payment determinations based on coverage and coding principles. Ideal candidates will possess ...
Job Title Medicare Appeals And Grievances Rn Senior Your Role The Medicare Appeals And Grievances ... Ensure proper procedure codes, diagnosis codes, drug names and dosages are reviewed for submitted ...
Job Title Medicare Appeals And Grievances Rn Senior Your Role The Medicare Appeals And Grievances ... Ensure proper procedure codes, diagnosis codes, drug names and dosages are reviewed for submitted ...
The successful RN candidate will review both medical (Medicare Part B/C) and pharmacy (Medicare Part D) appeals for Medicare/DSNP benefits, medical necessity, coding accuracy and medical policy ...
The successful RN candidate will review both medical (Medicare Part B/C) and pharmacy (Medicare Part D) appeals for Medicare/DSNP benefits, medical necessity, coding accuracy and medical policy ...
... Medicare Administrative Contractor, all facility policies and procedures and any state and other regulatory agencies. The Certified Coding Specialist must adhere to all CPT guidelines and ICD-10 ...
... Medicare Administrative Contractor, all facility policies and procedures and any state and other regulatory agencies. The Certified Coding Specialist must adhere to all CPT guidelines and ICD-10 ...
... Medicare Administrative Contractor, all facility policies and procedures and any state and other regulatory agencies. The Certified Coding Specialist must adhere to all CPT guidelines and ICD-10 ...
... Medicare Administrative Contractor, all facility policies and procedures and any state and other regulatory agencies. The Certified Coding Specialist must adhere to all CPT guidelines and ICD-10 ...
$25/hr
Medicare and Retirement Appeals Coder City: Atlanta State/Province: California Posting Start Date ... Our team is seeking dedicated and detail-oriented medical coding specialists who possess a Medical ...
$25/hr
Medicare and Retirement Appeals Coder City: Atlanta State/Province: California Posting Start Date ... Our team is seeking dedicated and detail-oriented medical coding specialists who possess a Medical ...
The successful RN candidate will review both medical (Medicare Part B/C) and pharmacy (Medicare Part D) appeals for Medicare/DSNP benefits, medical necessity, coding accuracy and medical policy ...
The successful RN candidate will review both medical (Medicare Part B/C) and pharmacy (Medicare Part D) appeals for Medicare/DSNP benefits, medical necessity, coding accuracy and medical policy ...
Job Title Medicare Appeals And Grievances Rn Senior Your Role The Medicare Appeals And Grievances ... Ensure proper procedure codes, diagnosis codes, drug names and dosages are reviewed for submitted ...
Job Title Medicare Appeals And Grievances Rn Senior Your Role The Medicare Appeals And Grievances ... Ensure proper procedure codes, diagnosis codes, drug names and dosages are reviewed for submitted ...
HCC Coding Educator
Fort Myers, FL · On-site +1
$27.57 - $35.84/hr
This role supports Medicare Advantage, ACO, and other risk-based contracts by ensuring Hierarchical ... The position serves as a clinical documentation and coding subject-matter expert, partnering with ...
HCC Coding Educator
Fort Myers, FL · On-site +1
$27.57 - $35.84/hr
This role supports Medicare Advantage, ACO, and other risk-based contracts by ensuring Hierarchical ... The position serves as a clinical documentation and coding subject-matter expert, partnering with ...
Job Title Medicare Appeals And Grievances Rn Senior Your Role The Medicare Appeals And Grievances ... Ensure proper procedure codes, diagnosis codes, drug names and dosages are reviewed for submitted ...
Job Title Medicare Appeals And Grievances Rn Senior Your Role The Medicare Appeals And Grievances ... Ensure proper procedure codes, diagnosis codes, drug names and dosages are reviewed for submitted ...
Job Title Medicare Appeals And Grievances Rn Senior Your Role The Medicare Appeals And Grievances ... Ensure proper procedure codes, diagnosis codes, drug names and dosages are reviewed for submitted ...
Job Title Medicare Appeals And Grievances Rn Senior Your Role The Medicare Appeals And Grievances ... Ensure proper procedure codes, diagnosis codes, drug names and dosages are reviewed for submitted ...
Candidate must have direct experience working on the Centers for Medicare & Medicaid Services Risk ... This role ensures compliance with CMS RADV guidelines, coding standards, and risk adjustment ...
Candidate must have direct experience working on the Centers for Medicare & Medicaid Services Risk ... This role ensures compliance with CMS RADV guidelines, coding standards, and risk adjustment ...
Coding Specialist
Oklahoma City, OK · Remote
Ensures all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI), or payer-specific guidelines. * Consult with physicians/ providers as needed to clarify any ...
Coding Specialist
Oklahoma City, OK · Remote
Ensures all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI), or payer-specific guidelines. * Consult with physicians/ providers as needed to clarify any ...
Medicare Coding information
See salary details
$15.87 - $17.55
6% of jobs
$18.74 is the 25th percentile. Wages below this are outliers.
$17.55 - $19.23
26% of jobs
The median wage is $20.19 / hr.
$19.23 - $20.91
31% of jobs
$20.91 - $22.60
7% of jobs
$23.31 is the 75th percentile. Wages above this are outliers.
$22.60 - $24.28
11% of jobs
$24.28 - $25.96
6% of jobs
$25.96 - $27.64
5% of jobs
$27.64 - $29.33
3% of jobs
$29.33 - $31.01
2% of jobs
$31.01 - $32.69
1% of jobs
$32.69 - $34.38
1% of jobs
$15
$22
$34
How much do medicare coding jobs pay per hour?
As of Jun 4, 2026, the average hourly pay for medicare coding in the United States is $22.42, according to ZipRecruiter salary data. Most workers in this role earn between $18.03 and $24.04 per hour, depending on experience, location, and employer.
What are the key skills and qualifications needed to thrive as a Medicare Coder, and why are they important?
To thrive as a Medicare Coder, you need a solid understanding of medical terminology, ICD-10-CM and CPT coding systems, and compliance with Medicare regulations, often supported by certification such as CPC or CCS. Proficiency with coding software, electronic health records (EHRs), and claims submission systems is typically required. Attention to detail, analytical thinking, and strong organizational skills help coders accurately interpret clinical documentation and manage complex billing requirements. These skills are essential to ensure accurate reimbursement, reduce claim denials, and maintain compliance with federal healthcare regulations.
What are some common challenges faced by professionals in Medicare coding, and how can these be managed effectively?
Medicare coding professionals often encounter challenges such as keeping up with frequent regulatory updates, accurately interpreting complex medical documentation, and ensuring compliance with strict billing guidelines. To manage these effectively, it’s important to participate in ongoing training, regularly review CMS updates, and utilize coding tools and resources. Collaborating closely with healthcare providers and billing teams can also help ensure accurate and timely claim submissions, reducing the risk of denials or audits.
What is Medicare coding?
Medicare coding refers to the process of assigning standardized codes to medical diagnoses, procedures, and services for patients covered under Medicare. These codes, such as ICD-10, CPT, and HCPCS, are used to ensure accurate billing and reimbursement from the Centers for Medicare & Medicaid Services (CMS). Proper Medicare coding is crucial for healthcare providers to receive correct payment and to comply with federal regulations. Coders must stay up to date with frequent changes in coding guidelines and Medicare policies.
How to become a Medicare reviewer?
To become a Medicare reviewer, candidates typically need a background in healthcare, such as nursing, medical coding, or health administration, along with knowledge of Medicare policies. Certification in medical coding (e.g., CPC, CCS) and familiarity with medical record review are often required, and some roles may require experience with Medicare claims processing or audits.
What is the difference between Medicare Coding vs Medical Billing?
| Aspect | Medicare Coding | Medical Billing |
|---|---|---|
| Primary Focus | Assigning medical codes for Medicare claims | Processing and submitting insurance claims |
| Certifications | Medical Coding Certification (e.g., CPC) | Billing and coding certifications often preferred |
| Work Environment | Hospitals, clinics, insurance companies | Medical offices, billing companies, hospitals |
| Industry Usage | Used mainly in Medicare and insurance claims | Used across various insurance providers |
Medicare Coding involves assigning specific codes to medical procedures and diagnoses for Medicare claims, focusing on accurate coding for reimbursement. Medical Billing encompasses the broader process of submitting claims, following up on payments, and managing patient billing. While they overlap, Medicare Coding is more specialized in coding accuracy for Medicare, whereas Medical Billing covers the entire billing cycle across multiple insurers.
More about Medicare Coding jobs
What states have the most Medicare Coding jobs? States with the most job openings for Medicare Coding jobs include:
What job categories do people searching Medicare Coding jobs look for? The top searched job categories for Medicare Coding jobs are:
Full-time
Medical
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Job description
Your Role
The Medicare Appeals and Grievances team is responsible for clinically reviewing member appeals and grievances that are the result of either a preservice, post-service or claim denial. The Medicare Appeals and Grievances RN Senior will report to Utilization Management Nurse Manager for Medi-Cal and Medicare Appeals and Grievances. In this role, you will perform accurate and timely clinical review of provider or member appeals, or appeals initiated by someone qualified to speak on behalf of the member. The RN performs redetermination appeal reviews for members utilizing CMS and/or DHCS approved guidelines, BSC plan policies and nationally recognized clinical criteria across lines of business or for a specific line of business such as Medicare, Medi-Cal, including dual-eligibility products; therefore, the Medicare Appeals RN has understanding and knowledge of the Medicare Provider Manual, National Coverage Determination (NCD) guidelines, Local Coverage Determination (LCD) Guidelines, DHCS Medi-Cal Guidelines, Milliman Care Guidelines (MCG), BSC Pharmacy Policies, BSC Formularies and nationally recognized sources such as NCCN and ACOG. The successful RN candidate will review both medical (Medicare Part B/C) and pharmacy (Medicare Part D) appeals for Medicare/DSNP benefits, medical necessity, coding accuracy and medical policy compliance, as well as grievances for clinical issues.
Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
Your Knowledge and Experience
- Bachelor of Science in Nursing or advanced degree preferred
- Requires a current CA RN License
- Requires at least 5 years of prior experience in nursing, healthcare or other related fields
- Knowledge of Medicare, CMS and health plan benefit reviews
- Knowledge of CPT, ICD-10, HCPCS and billing practices
- Demonstrate the ability to act independently using sound clinical judgement
- Knowledge of both medical (Medicare Part B/C) and pharmacy (Medicare Part D) appeals for Medicare/DSNP benefits, medical necessity, coding accuracy and medical policy compliance, as well as grievances for clinical issues strongly preferred
Hybrid Virtual Work
This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.