Coding Business Analyst II - Content Updates

About the role

Perform various analysis and interpretation to link business needs and objectives for assigned function.

Responsibilities

• Ensuring our internal claims coding editors remain accurate, up to date, and compliant.
• Review, analyze, and interpret coding, reimbursement, and regulatory guidelines to ensure organizational compliance and payment integrity.
• Develop, implement, and maintain Payment Policies, reimbursement methodologies, and claims editing logic to support accurate claims adjudication.
• Monitor, report on, and track regulatory, coding, and policy updates, ensuring timely implementation and communication of changes across impacted stakeholders.
• Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of new systems.
• Identify and analyze user requirements, procedures, and problems to improve existing processes.
• Perform detailed analysis on assigned projects, recommend potential business solutions and assist with implementation.
• Identify ways to enhance performance management and operational reports related to new business implementation processes.
• Develop and incorporate organizational best practices into business applications.
• Lead problem solving and coordination efforts between various business units.
• Assist with formulating and updating departmental policies and procedures.
• Performs other duties as assigned.
• Complies with all policies and standards.

Qualifications

• Bachelor's degree in related field or equivalent experience.
• 2+ years of business process analysis, preferably healthcare (i.e. documenting business process, gathering requirements) or claims payment/analysis experience.

Preferred qualifications

• Knowledge of managed care information systems and experience in benefits, pricing, contracting or claims preferred.
• Knowledge of provider reimbursement methodologies preferred.
• Previous structured testing experience preferred.
• Coding certification such as a CPC or similar.
• Claims coding appeals and auditing experience.
• Claims research experience.
• Excel skills with pivot tables and VLOOKUPs.

Pay

$56,200.00 - $101,000.00 per year

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible approach to work with remote, hybrid, field or office work schedules