Coding Business Analyst II

Job Summary

To support business initiatives in a remote environment, the full-time Coding Business Analyst II will perform analysis and interpretation of coding and reimbursement guidelines, ensure compliance, and develop policies for accurate claims adjudication.

Key responsibilities

• Ensure internal claims coding editors are accurate, up to date, and compliant with regulatory guidelines
• Develop and implement Payment Policies and claims editing logic to support accurate claims processing
• Monitor and report on regulatory and coding updates, ensuring timely communication across stakeholders

Required qualifications

• Bachelor's degree in a related field or equivalent experience
• 2+ years of business process analysis or claims payment/analysis experience, preferably in healthcare
• Knowledge of managed care information systems and provider reimbursement methodologies
• Previous structured testing experience is preferred
• Coding certification such as a CPC or similar is preferred