Coding Validation Specialist (Behavioral Health / Substance Use Disorder)
Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.
The Coding Validation Specialist (CVS), Behavioral Health / Substance Use Disorder reviews provider medical records to validate the accuracy of outpatient facility and professional behavioral health and substance use disorder (SUD) claims. This role requires specialized knowledge of psychiatric, psychotherapy, and SUD treatment coding, including DSM-5-based diagnosis coding, H-codes, and applicable CPT and HCPCS Level II codes, to ensure the accuracy of coding, billing, and documentation. The CVS reports findings, communicates results, ensures compliance with regulatory, payer, and client requirements, and maintains quality and productivity standards. This role may be fille
