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Coding and Cost Analyst I - medical claims coding and claim edit review, Geisinger Health Plan (Pennsylvania resident)
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Job Description
- Req#: R-90125
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Healthcare benefits for full-time and part-time positions from day one, including vision and dental
- Opportunity for career advancement and professional development within the organization
- Supportive and collaborative work environment with a focus on teamwork
- Work-from-home position, providing flexibility in your work environment
- Chance to contribute to the strategic and financial goals of the organization while ensuring compliance with regulations
What to Expect (Job Responsibilities):
- Conduct thorough reviews of billed services, authorizations, and medical records to make reimbursement recommendations
- Provide resources and support to other Health Plan departments regarding coding and billing
- Complete clinical reviews related to claims, appeals, and the grievance process
- Validate claim payments based on Plan contracts and assist with high dollar claim reviews
- Create and maintain reports to track department data and assist with onboarding new team members
What is Required (Qualifications):
- Minimum of 3 years of relevant experience in healthcare coding or related field
- High School Diploma or Equivalent (GED) required; graduate from a specialty training program preferred
- Certification as a CPC (Certified Professional Coder) or CCS (Certified Coding Specialist) is required
- Strong computer literacy and critical thinking skills
- Ability to work independently and as part of a team
How to Stand Out (Preferred Qualifications):
- Minimum of 2 years of clinical experience
- Completion of a specialty training program in healthcare coding
- LPN (Licensed Practical Nurse) certification preferred
#HealthcareServices #RemoteWork #CareerGrowth #HealthcareBenefits #Teamwork
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