CLINICAL CODING ANALYST

CLINICAL CODING ANALYST

Key Responsibilities

• Review and analyze claims that have been denied due to coding-related issues, including diagnosis codes (ICD-10-CM), procedure codes (CPT/HCPCS), and related modifiers.
• Identify coding discrepancies, documentation deficiencies, and other factors contributing to claims denials, utilizing a thorough understanding of coding guidelines, industry standards, and regulatory requirements.
• Collaborate with coding teams, healthcare providers, and revenue cycle stakeholders to obtain necessary documentation and information for claims resubmission.
• Prepare and support coding‑based appeals by developing clear clinical and coding justifications
• Review medical records, payer policies, and coding guidelines to support appeal arguments
• Conduct in-depth coding audits and analysis to validate the accuracy, completeness, and compliance of coding practices, and ensure align...