Certified Coding Analyst

Job Summary

Working remotely, the full-time Certified Coding Analyst will perform high-level coding, audits, and analyses to ensure accurate application of medical coding standards within claims and operational workflows, while serving as a resource for coding expertise across various internal departments.

Key responsibilities

• Review and code clinical documentation using ICD, CPT, HCPCS, and internal coding guidelines to ensure accurate claims processing
• Conduct audits of claims and documentation to identify coding discrepancies and recommend corrective actions
• Troubleshoot coding-related issues across operational processes, collaborating with cross-functional teams to resolve discrepancies efficiently

Required qualifications

• Bachelor's degree or equivalent experience in a related field
• 3+ years of medical coding experience within a Health Plan or Payment Integrity department
• Current professional coding certification from a nationally recognized credentialing organization (e.g., AAPC or AHIMA)
• Acceptable certifications may include CPC, CPC-H (COC), CCS, CCS-P, RHIT, or RHIA
• Certification must be maintained in good standing throughout employment