Medical Coding Analyst

Remote Full-time
Job Description:
• Responsible for reviewing and researching new code changes that are released by the Coding Authorities (AMA, CMS) for system implementation for PPO and HMO Commercial Business.
• AMA (American Medical Association): The AMA is responsible for maintaining and updating the Current Procedural Terminology (CPT) codes, which are used for medical billing and coding in the U.S. healthcare system.
• CMS (Centers for Medicare & Medicaid Services): CMS oversees the Healthcare Common Procedure Coding System (HCPCS) and International Classification of Diseases (ICD) codes, ensuring standardized coding for Medicare, Medicaid, and other healthcare programs.

Top 3 Required Skills/Experience –
• Must be knowledgeable in use of CPT, HCPCS, ICD-10-CM and ICD-10-PCS code books
• RHIT or RHIA Certification Required
• Ability to analyse, investigate and organize ideas in defining and formulating solutions
Required Skills/Experience – The rest of the required skills/experience. Include:
• Proficient in current industry standard PC applications and systems (e.g. Word, Excel and Microsoft Office)
• Ability to work independently, within a team environment and handle multiple priorities
• Great oral and written communication skills
• Other related skills and/or abilities may be required to perform this job.
• Must be knowledgeable in use of CPT, HCPCS, ICD-10-CM and ICD-10-PCS code books
• RHIT or RHIA with specialty certification of CCS, CCS-P preferred
• Works collaboratively with Physicians and other team members
• Knowledge of PPO and HMO claim systems and benefits a plus.
Preferred Skills/Experience –
• Experience working with the client /BCN benefits and/or claims preferred
• Previous experience working with NASCO, MOS and/or BCU systems preferred
Education/Certifications – Include:
• Bachelor's degree in related field
• Certified Professional Coder
HM Notes:
• Healthcare experience is mandatory.
• While the candidate does not need full-fledged coding experience, they should have a background in coding and will be responsible for reviewing and researching new code changes released by the Coding Authorities (AMA, CMS) for system implementation in PPO and HMO Commercial Business.
• The client is looking for an Analyst, not a strictly coding-focused candidate.
Skills Required:
• Looking for an Analyst with strong medical coding experience.
• Must be able to analyze coding updates, perform root cause analysis, and document solutions.
• Strong background in CPT, ICD-10-CM, ICD-10-PCS, and HCPCS codes.
• Candidate must have in-depth knowledge of coding and billing, though no billing work will be performed.
• The primary responsibility is to implement new codes released by CMS and AMA and document these updates.
• Strong analytical skills required, with expertise in Medical Codes, surgery codes, and lab code sets.
• Must have both coding and analytical experience—not just one.
• Hybrid role (onsite once a week).
• Certified Professional Coder (CPC) certification is required.
Interview format: In-person preferred; virtual available if necessary.

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