State Licensed Coding Analyst

Job Summary

Seeking a skilled IBR Policy and Content Development Analyst, this remote position will focus on developing and enhancing clinical and coding solutions, serving as the primary subject matter expert for payment integrity policies while collaborating with cross-functional teams.

Key responsibilities

• Review and update audit concepts based on regulatory changes and client needs, including data analysis and documentation updates
• Conduct research to assess the impact of policy changes on audit concepts and document findings
• Collaborate with teams to develop clinical solutions and ensure compliance with coding standards and payer policies

Required qualifications

• 3+ years of experience in payment integrity or auditing facility claims
• At least one coding certification (RHIA, RHIT, CCS, CPC, CPMA) or an active RN/LPN license
• Deep understanding of Medicare and Commercial coding rules and payment systems
• Proficiency in Microsoft Office Suite, including Excel and SharePoint
• Experience utilizing AI tools and automation platforms for clinical research optimization