Medical Coder - Edit Configuration Analyst

Role Overview

The Edit Configuration Analyst I performs research on editing concepts and analyzes related claims data, applying coding standards, industry knowledge, and federal regulations to ensure correct billing practices.

What You Will Do

Review and analyze billing for medical appropriateness and charges, research and interpret coding and billing standards, prepare clear and concise findings, and assist with internal claim recommendations.

Why It Might Be a Fit

This role requires two years of experience with inpatient/outpatient medical procedure coding and billing, including medical insurance billing, medical insurance auditing, line-item review, appeals, and reimbursement utilizing the UB-04 form and/or CMS 1500.

Requirements

• Two (2) years of experience with inpatient/outpatient medical procedure coding and billing
• Two (2) years of experience utilizing coding guidelines and resources
• Two (2) years of experience reading and abstracting medical codes from medical records
• One (1) year of experience in data mining/data modeling, medical claim analytics preferred
• Basic SQL knowledge (RA & UAT)
• Intermediate to proficient Microsoft Excel and Word skills
• Required licensures, professional certifications, and/or Board certifications as applicable

Benefits

• Medical, dental and vision coverage with low deductible & copay
• Life insurance
• Short and long-term disability
• Paid Parental Leave
• 401(k) + match
• Employee Stock Purchase Plan
• Generous Paid Time Off
• 10 paid company holidays
• Tuition reimbursement
• Flexible Spending Account
• Employee Assistance Program
• Sick time benefits

Originally posted on Himalayas