Coding Analyst II

🔥 14 hours ago

🌵 Arizona, Florida, +15 more states – Remote

🌵 Arizona – Remote 🐊 Florida – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote 🌾 Nebraska – Remote 🌾 North Dakota – Remote 🌪️ Oklahoma – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🏰 Missouri – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⚔️ Virginia – Remote 🧀 Wisconsin – Remote

💵 $45.9k - $68.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Medica

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1975

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Medica is a nonprofit health plan and insurer with over 50 years of experience that provides individual & family plans, Medicare, Medicaid, and employer-provided health plans. It offers member services and tools for finding providers, managing benefits and claims, wellness programs, and community-focused initiatives through the Medica Foundation to advance health equity.

📋 Description

• Review and code clinical documentation using ICD, CPT, HCPCS, and internal coding guidelines • Validate coding accuracy for compliant billing, reimbursement, and data reporting • Research missing or unclear information for proper code assignment • Complete timely coding reviews supporting accurate claims processing • Audit claims, encounters, and documentation to detect coding errors or inconsistencies • Analyze coding patterns to identify trends, risks, and gaps affecting payment accuracy • Document audit findings and recommend corrective actions • Communicate audit results to internal partners • Investigate coding impacts on claims adjudication, reimbursement, and provider disputes • Collaborate with configuration, operations, and provider teams to resolve coding issues • Verify coding rules within system logic and flag discrepancies • Support issue triage workflows • Apply coding regulations, payer guidelines, and organizational policies • Maintain regulatory, audit, and documentation compliance • Participate in coding quality and process improvement initiatives • Monitor coding rule updates and support implementation of required changes • Guide junior analysts on coding practices, documentation requirements, and audit methods • Assist with training, documentation updates, and knowledge-sharing • Perform other duties as assigned

🎯 Requirements

• Bachelor's degree in Health Information Management, Healthcare Administration, Business, or a related field, or equivalent combination of education and experience • 3+ years of work experience beyond degree in coding for a health plan, insurance payer, facility and/or hospital • Coding certification required: CCA, CPC-P, CPC, CPC-H, CCS, CCS-P, RHIT, or RHIA • Knowledge of revenue codes, NUBC guidelines, UB-04 claim requirements, DRGs, and facility reimbursement methodologies • Experience analyzing medical coding and claim data • Understanding of coding impacts on claim adjudication, provider reimbursement, and payment accuracy • Experience researching and interpreting coding guidelines, industry standards, and healthcare billing requirements • Analytical and problem-solving skills to investigate coding issues and identify root causes • Ability to track trends and identify process improvement opportunities • Strong written and verbal communication skills • Primary home address must be in a 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, or WI • Must be legally authorized to work in the United States at the time of application • Medica does not offer work visa sponsorship

🏖️ Benefits

• Competitive medical insurance • Dental insurance • Vision insurance • PTO • Holidays • Paid volunteer time off • 401K contributions • Caregiver services • Other total rewards benefits