Coding Quality Analyst

Job Summary

A company is looking for a Coding Quality Analyst for a national remote position.

Key Responsibilities:

• Perform quality audits of clinical review cases of CPT, HCPCS, and modifiers assigned to codes on claims
• Determine accuracy of medical coding/billing and payment recommendation for pre-payment claims
• Identify aberrant billing patterns and trends, evidence of fraud, waste or abuse, and recommend providers to be flagged for review

Required Qualifications:

• High school diploma / GED
• Certified Coder AHIMA or AAPC Certified coder with medical record auditing and coding/billing experience
• 2+ years of experience as a AHIMA or AAPC Certified coder with 2+ years of CPT/HCPCS/ICD - 10/CM/PCS coding experience
• Strong medical record review experience
• Knowledge of health insurance business, industry terminology, and regulatory guidelines