Medical Coding Analyst

Job Summary

Medical Coding Analyst, a full-time remote position, is responsible for bridging clinical terminology and operational execution by developing policies, ensuring accurate coding compliance, and overseeing claims while providing insights for financial and risk management.

Key Responsibilities

• Support the design and implementation of clinical protocols, SOPs, and medical policies
• Analyze medical records to ensure accurate code assignments and maintain compliance with regulations
• Evaluate treatment plans and audit claims to identify discrepancies and recommend corrective actions

Required Qualifications

• Successful completion of a medical coding certification program
• Bachelor's degree in Nursing, Health Information Management, or a related field
• 5+ years of medical coding experience and 2+ years in a health plan, TPA, or managed care organization
• Expert knowledge of anatomy, medical terminology, and coding systems
• Demonstrated ability to analyze data and support decision-making related to fraud, waste, and abuse