Coding Analyst II
New
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MedicaHealth Insurance
Primary home address located within any state where Medica is registered as an employer - AR, AZ, FL, GA, IA, IL, KS, KY, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, WIFull-TimeMiddle
Salary45,900 - 68,775 USD per year
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Job Details
- Experience
- 3+ years of medical coding experience
- Required Skills
- Microsoft Excel
Requirements
- 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 organization such as AAPC or AHIMA.
- Must maintain certification in good standing throughout employment.
- Experience supporting coding-related system configuration, business rules, or claims processing logic (preferred).
- Experience as a subject matter expert for cross-functional stakeholders (preferred).
- Familiarity with coding and reimbursement platforms like Optum EncoderPro, Optum CES, or HealthRules (preferred).
- Intermediate Microsoft Excel skills including pivot tables and formulas (preferred).
- Ability to work successfully in a remote work environment with minimal supervision.
Responsibilities
- Review and code clinical documentation using ICD, CPT, HCPCS, and internal guidelines.
- Validate coding accuracy to support compliant billing and data reporting.
- Perform audits of claims and documentation to detect coding errors or inconsistencies.
- Analyze coding patterns to identify trends, risks, or gaps affecting payment accuracy.
- Investigate coding impacts on claims adjudication, reimbursement, and provider disputes.
- Verify coding rules within system logic and flag discrepancies for correction.
- Provide guidance to junior analysts on coding practices and audit methods.
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