Coding Quality Analyst

Location: Remote
Compensation: Hourly
Staff Reviewed: Thu, Feb 08, 2024
This job expires in: 15 days

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

COMPLETE JOB DESCRIPTION

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