Geisinger
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:
- Opportunity for career advancement and growth within the organization
- Work remotely from the comfort of your home
- Comprehensive healthcare benefits from day one, including vision and dental
- Supportive and collaborative work environment
- Chance to contribute to the improvement of patient care and community health
What to Expect (Job Responsibilities):
- Conduct thorough reviews of billed services, authorizations, and medical records to ensure compliance with regulations
- Provide recommendations for correct coding, billing, and reimbursement to support other Health Plan departments
- Validate and review pended and reconsidered claims based on industry standards and guidelines
- Assist in onboarding new team members and participate in group discussions on challenging medical reviews
- Create and maintain reports to track department data and support strategic goals
What is Required (Qualifications):
- Minimum of 3 years of relevant experience in healthcare coding or billing
- High School Diploma or Equivalent (GED) required; Graduate from a Specialty Training Program preferred
- At least 1 certification required: CPC or CCS
- 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
- LPN certification preferred
- Experience with claims, claim edits, appeals, and the grievance process
- Familiarity with CPT guidelines and CMS regulations
- Strong communication and teamwork skills
#HealthcareServices #RemoteWork #CareerOpportunity #CodingCertification #DiverseWorkforce
"We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer."About the company
Geisinger is a health and wellness organization focused on making better health easier for our communities through primary care, specialty medicine, hospitals, clinics, health insurance, medical education and research.
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