Benefits Configuration & Code Mapping Analyst

Position: Benefits Configuration & Code Mapping Analyst

Client: Global Healthcare IT Consulting Company

Location: Remote (PST Hours)

Length: 4-5 month Contract with high potential for extensions

Start Date: ASAP

Position Overview

Translate Medicare Advantage benefit designs and coverage requirements into accurate code sets and configuration rules that support claims processing and benefit administration.

Key Responsibilities

• Review plan documents and medical policies to map covered services, exclusions, prior authorization requirements, and benefit limits to appropriate claims codes.
• Develop benefit-to-code crosswalks using CPT, HCPCS, ICD-10, CDT, revenue codes, Place of Service, Type of Bill, modifiers, and provider specialty indicators.
• Research and apply Medicare coverage requirements, including NCDs, LCDs, CMS guidance, and payer medical policies.
• Define coding logic for frequency limits, medical necessity, diagnosis requirements, and other coverage restrictions.
• Partner with claims and configuration teams to ensure accurate benefit assignment, cost sharing, and claims adjudication.
• Document configuration requirements, validate benefit setup through claims testing, and resolve mapping or configuration issues.

Required Qualifications

• Healthcare payer experience supporting benefit configuration, claims adjudication, clinical policy, or medical coding.
• Hands-on experience translating benefit language into claims-based code sets and operational rules.
• Strong knowledge of Medicare Advantage benefits, Original Medicare coverage requirements, and supplemental benefits.
• Proficiency with medical and claims coding structures and experience interpreting NCDs, LCDs, CMS manuals, and medical policies.
• Strong analytical, documentation, and cross-functional collaboration skills.

Preferred Qualifications

• Coding or HIM certification, such as CPC, CCS, RHIT, RHIA, CRC, or CPMA.
• Experience with Evidence of Coverage, Summary of Benefits, or Plan Benefit Package documents.
• Experience with claims platforms, benefit configuration systems, testing, or configuration quality assurance.

Why Join Us?

• 401(k) Matching Plan
• Medical, Dental, & Vision Plans
• Relationship Driven Process to Find Your Best Fit
• 6 Paid Holidays
• Regular Meetings to Ensure Quality in Your Engagement

How to Apply:

Straightforward, easy one-click apply.

EEO Statement:

Medasource is an equal opportunity employer that does not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth, lactation and related medical conditions), gender identity or gender expression, sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws and Ordinances.

Benefits & Perks:

Medasource offers competitive medical, dental, vision, Health Savings Account, Dependent Care FSA, and supplemental coverage with plans that can fit each employee’s needs. We offer a 401k plan that includes a company match and is fully vested after you become eligible, paid time off, sick time, and paid company holidays.

Pay Disclaimer:

The pay range for this job level is a general guideline only and not a guarantee of compensation or salary. Additional factors considered in extending an offer include (but are not limited to) responsibilities of the job, education, experience, knowledge, skills, and abilities, as well as internal equity, alignment with market data, applicable bargaining agreement (if any), or other law