Senior Edit Resolution Analyst, CPC

Job Summary

A company is looking for a Senior Edit Resolution Analyst, CPC/CCS.

Key Responsibilities

• Manage escalated and high-risk grievance and appeal cases
• Serve as a resource for complex inquiries and interpret regulatory changes
• Lead the creation and refinement of SOPs and training materials

Required Qualifications

• CPC or CCS or equivalent credentials required
• 3+ years of related coding experience
• Associate's degree preferred
• Advanced knowledge of grievance and appeals handling in healthcare
• Proficiency using AI tools for developing intelligent prompts and agents