Job Description

Working remotely, the full-time Certified Coding Analyst will perform high-level coding, audits, and analyses to ensure accurate application of medical coding standards within claims and operational workflows, while serving as a resource for coding expertise across various internal departments. Key responsibilities Review and code clinical documentation using ICD, CPT, HCPCS, and internal coding guidelines to ensure accurate claims processing Conduct audits of claims and documentation to identify coding discrepancies and recommend corrective actions Troubleshoot coding-related issues across operational processes, collaborating with cross-functional teams to resolve discrepancies efficiently Required qualifications Bachelor's degree or equivalent experience in a related field 3+ years of medical coding experience within a Health Plan or Payment Integrity department Current professional coding certification from a nationally recognized credentialing organization (e.g., AAPC or AHIMA) Acceptable certifications may include CPC, CPC-H (COC), CCS, CCS-P, RHIT, or RHIA Certification must be maintained in good standing throughout employment

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