Pennsylvania Licensed Coding Analyst

Job Summary

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

Key Responsibilities

• Conduct thorough reviews of billed services, authorizations, and medical records to make reimbursement recommendations
• Support other departments by providing recommendations for correct coding and appropriate billing
• Validate claim payments based on Plan contracts and assist in clinical reviews related to claims and appeals

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 Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) required
• LPN preferred
• Relevant experience may include a combination of work experience and completed specialty training programs