State Licensed Coding Analyst

A company is looking for an Edit Configuration Analyst.

Key Responsibilities

Review and analyze complex billing for medical appropriateness and compliance

Assist in daily operations and design educational programs for staff

Monitor claims for accuracy and collaborate with teams to enhance coding practices

Required Qualifications

Current coding certification (AHIMA or AAPC) or medical license (RN, MD) required

5 years of experience in a clinically related field, including coding or auditing

Extensive knowledge of hospital billing, claims data, and coding standards

Experience with MS Office Suites and familiarity with international billing platforms

Knowledge of payer reimbursement policies and medical necessity criteria