Analyst, Pre-Pay Dispute Coding-CPC (Remote)
Remote · United States
Job Summary
Analyst role focusing on investigation and resolution of provider dispute coding, auditing non-medical records for billing accuracy, determining whether documentation supports services, and communicating determinations to providers. Responsibilities include overturning or upholding denials per guidelines, identifying coding errors, collaborating with internal teams to capture issues, completing required data points in internal systems, and contributing to process improvements to stay aligned with current coding regulations and Molina guidelines.
Required Qualifications
- At least 2 years of experience in medical coding or billing.
- Active and unrestricted Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification.
- Strong attention to detail and ability to independently read and comprehend the details of medical records.
- Comfortable working in a production-centric environment with high quality standards.
- Ability to use Microsoft Office including Outlook, Word, and Excel.
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