QA - HIM Services

About the role

The Medical Coding Edits and Denial Quality Analyst is responsible for analyzing, reviewing, and resolving coding-related claim edits and insurance denials. This role involves performing root-cause analysis on denied claims, identifying coding trends that lead to financial loss, and providing feedback to the coding and clinical teams.

What you'll do

• This position may perform all or most of the primary duties listed below
• Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team…
• Auditing and reviewing medical documentation for appropriate ICD and CPT coding
• And ensuring that codes tally with doctors’ diagnosis
• Asking explanation from physicians when code assignments are not straightforward or

What you need

• 3–5 yrs of experience
• Medical coding
• Root cause analysis
• POS
• Tally
• Pharmacology
• BBA