Certified Professional Coder Analyst

Job Summary

Supporting the accuracy of healthcare claims processes, the full-time remote Health Admin Services Senior Analyst will analyze complex claims issues, review coding and auditing practices, and collaborate with internal teams and customers to identify solutions.

Key responsibilities

• Analyze complex healthcare claims and recommend appropriate resolutions
• Review claims edits and audit groupings for accuracy in alignment with policies
• Research medical and reimbursement policies to assess their impact on claims processing

Required qualifications

• Minimum of 1 year of experience researching or interpreting medical or claims-processing policies
• Certified Professional Coder (CPC) certification
• Experience with healthcare claims data or claims-processing systems
• Bachelor's degree or equivalent relevant experience
• Understanding of healthcare reimbursement methodologies and claims adjudication processes