Job Summary
A healthcare company has a current position open for a Remote Certified Medical Coding Analyst.
Core Responsibilities of this position include:
- Reviewing and approving complex, high dollar inquiries up to a defined threshold in edit savings
- Applying Editing Product and utilize current edit logic and coding guidelines
- Researching and auditing medical records for complex and multi-specialty provider claims
Applicants must meet the following qualifications:
- Current active CPC or CCS or equivalent credentials
- 3+ years experience or equivalent combination of education & work within healthcare payer or provider
- Knowledge of healthcare reimbursement policies, state and federal regulations and industry standards
- Knowledge of correct coding and industry standard claim adjudication guidelines and policies
- Ability to translate coding and adjudication guidelines, policies, and references into edit policies and rules
- Excellent verbal & written communication skills with project management skills
