Senior Claims Coding Analyst - Remote

Overview

The Sr Claims Coding Analyst is responsible for making complex coding decisions on claims and appeals to ensure proper claims payments and to maintain Healthfirst’s claims editing systems.

In Short

• Analyze and interpret health insurance benefits and coverage details.
• Assign procedure and diagnosis codes accurately.
• Verify coding accuracy to support compliant billing.
• Collaborate with clinical and claims teams to clarify coverage issues.
• Maintain up-to-date knowledge of coding guidelines and regulations.
• Support audits and quality assurance initiatives.
• Provide coding guidance and training to junior analysts.
• Act as a subject matter expert for complex provider issues.
• Work independently with sound judgment on claims matters.
• Participate in setting claims policy aligned with regulatory standards.

Requirements

• Coding certification from AAPC or AHIMA.
• 5-10 years of experience in medical coding.
• Prior experience with Medicare and Medicaid coding.
• Knowledge of anatomy and medical terminologies.
• Strong time management and problem-solving skills.
• Intermediate skills in Outlook, Word, Excel, and PowerPoint.
• Ability to communicate effectively in writing.
• High school diploma or GED required.
• Bachelor’s degree preferred.

Benefits

• Medical, dental, and vision coverage.
• Incentive and recognition programs.
• Life insurance.
• 401k contributions.
• Competitive compensation package.