Coding Business Analyst II

Job Summary

Performing detailed analysis and policy reviews, the full-time Coding Business Analyst II will ensure compliance and payment integrity by reviewing state-specific and corporate payment policies, analyzing coding and reimbursement guidelines, and developing payment policies in a remote setting.

Key responsibilities

• Review and analyze coding, reimbursement, and regulatory guidelines to ensure compliance and payment integrity
• Develop and maintain payment policies and claims editing logic to support accurate claims adjudication
• Monitor and report on regulatory and policy updates, ensuring timely implementation and communication across stakeholders

Required qualifications

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