Senior Consultant - Certified Professional Coder Analyst

NYSTEC is a nonprofit technology consulting company, advising agencies, organizations, institutions, and businesses since 1996. We're independent and vendor-neutral, so we have our clients' best interests at heart. At NYSTEC, we know that we succeed when individuals and teams flourish personally and professionally, so our benefits and perks support that mindset.

As a senior consultant - Certified Professional Coder (CPC) analyst in the Policy and Program Strategic Solutions practice area, you will collaborate with team members to navigate complex stakeholder environments, communicate effectively with both technical and non-technical audiences, and build trusted client relationships while advancing policy and operational goals.

Serving as a CPC analyst, your day-to-day role as a NYSTEC consultant will require expertise in medical coding, healthcare claims processes, and business analysis, along with strong client engagement and diplomacy skills.

• Analyze and evaluate medical coding systems and transaction code sets used in Medicaid administration.
• Conduct research on coding standards and recommend improvements aligned with regulatory and policy requirements.
• Translate complex coding and regulatory requirements into clear business and policy recommendations for diverse stakeholders.
• Support claims adjudication analysis, including interpretation of claim adjustment reason codes (CARC) and remittance advice remark codes (RARC) codes.
• Engage directly with clients and stakeholders, facilitate discussions, present findings, and manage expectations with professionalism and diplomacy.
• Navigate sensitive or complex policy and operational discussions with tact while balancing client needs, regulatory requirements, and organizational priorities.
• Collaborate with cross-functional teams to integrate coding practices into healthcare policy and operations.
• Develop clear, high-quality documentation and deliverables for NYSTEC clients.

• CPC credential from the American Academy of Professional Coders (AAPC), or equivalent certification from American Health Information Management Association (AHIMA) (e.g., Certified Coding Specialist [CCS])
• Exceptional knowledge of Medicare and Medicaid billing guidelines and regulatory requirements
• Experience with medical code sets, including current procedural terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), ICD-10-Procedure Coding System (PCS), CARC, and RARC
• Solid understanding of the claims adjudication lifecycle
• Research and analytical skills, particularly in medical coding and policy integration
• Proficient with technical writing and documentation abilities
• Proficient with Microsoft (MS) Office Suite (Word, Excel, PowerPoint, Outlook), MS Project, and SharePoint

Preferred/Desired Qualifications

• Inpatient coding certification is a plus.
• Ten years of relevant experience is preferred.
• Excellent written and verbal communication skills, with the ability to tailor messaging to varied audiences
• Ability to engage clients, build trust, and maintain strong working relationships in complex environments
• Diplomacy, facilitation, and stakeholder management skills, especially when navigating sensitive or competing priorities
• Ability to work independently, manage priorities, and collaborate with diverse teams
• Ability to represent NYSTEC effectively with clients and stakeholders

Education and Experience

• A bachelor's degree in public health, healthcare administration, public policy, a technical field, or a related discipline, with a minimum of five years of relevant experience.
• An equivalent combination of advanced education, training, and experience will be considered.

The target base salary for this position is $84,497.00 to $109,846.00 per year. When determining compensation, we analyze and carefully consider several factors, including skill set, experience, location, and job-related qualifications.

It is NYSTEC's policy to provide equal employment opportunity (EEO) to all individuals, regardless of actual or perceived race, color, creed, religion, sex, or gender (including pregnancy, childbirth, and related medical conditions), gender identity or gender expression (including transgender status), age, national origin, ancestry, citizenship status, physical or mental disability, protected medical condition as defined by applicable state or local law, genetic information, military service and veteran status, sexual orientation, marital status, or any other characteristic protected by local, state, or federal laws and ordinances. NYSTEC is strongly committed to this policy and believes in the concept and spirit of the law.

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please contact recruitment@nystec.com if you require a reasonable accommodation to apply for or to perform this job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.

Applicants must be authorized to work in the United States without the need for visa sponsorship now or in the future.

Learn more about NYSTEC by visiting www.nystec.com.