Pennsylvania Licensed Coding Analyst

Job Summary

A company is looking for a Coding and Cost Analyst I to perform medical claims coding and claim edit review.

Key Responsibilities

• Conduct thorough reviews of billed services, authorizations, and medical records to make reimbursement recommendations
• Complete clinical reviews related to claims and assist in analyzing clinical risk across departments
• Create and maintain reports to track department data and assist with onboarding new team members

Required Qualifications, Training, and Education

• High School Diploma or Equivalent (GED) required; Graduate from Specialty Training Program preferred
• Minimum of 3 years of relevant experience required; 2 years of clinical experience preferred
• Certification as a CPC (Certified Professional Coder) through AAPC or CCS (Certified Coding Specialist) through AHIMA required
• LPN certification preferred
• Experience with medical claims coding and compliance with industry standards and regulations