Senior Claims Coding Analyst

Job Summary

Serving as a coding subject matter expert and triage coordinator, the full-time Senior Claims Coding Analyst will optimize provider dispute resolutions, analyze claims data, and improve administrative costs while working remotely.

Key responsibilities

• Coordinate resolution pathways for provider disputes based on coding complexity and financial impact
• Analyze dispute populations to identify trends and develop standardized resolution strategies
• Provide guidance to Claims Coding Analysts and lead continuous improvement efforts to enhance provider and consumer experiences

Required qualifications

• Coding class completion and/or certification from AAPC or AHIMA, including CPC or equivalent
• Previous professional coding and/or claims payment experience on both payer and provider sides
• Experience in researching and applying coding guidelines to complex claims or provider disputes
• Ability to independently analyze claims and disputes for defensible coding and payment decisions
• High school diploma or GED from an accredited institution