Remote Healthcare Coding & Cost Analyst

Geisinger; Elm (PA); Remote; USD 60,000 - 85,000; Full time

Job summary

Geisinger is seeking a Remote Medical Coder to perform thorough reviews of billed services, authorizations, and plan documents. You will make reimbursement recommendations based on CPT, CMS guidelines and policies while ensuring compliance with state and federal regulations.

The role requires CPC or CCS certification, at least 3 years of relevant experience, and familiarity with HIPAA privacy standards. Responsibilities include supporting multiple departments, generating reports, and

Qualifications

• CPC or CCS certification required; LPN preferred.
• Minimum 3 years relevant experience required.
• 2 years clinical experience preferred.
• Education: HS Diploma/GED required; specialty training preferred.

Responsibilities

• Review and recommend correct coding, billing, and reimbursement.
• Complete clinical reviews related to claims, edits, appeals and grievances.
• Analyze contracts, policies, CMS guidelines and industry standards for reimbursement.
• Validate claim payments based on plan contracts and pharmacy interactions.
• Create and maintain reports tracking department data.
• Assist onboarding new team members and participate in ad hoc workgroups.

Skills

Computer Literacy

Critical Thinking

Organizing

Education

High School Diploma or GED (Required)

Specialty Training Program (Preferred)

Job description

Geisinger is seeking a Remote Medical Coder to perform thorough reviews of billed services, authorizations, and plan documents. You will make reimbursement recommendations based on CPT, CMS guidelines and policies while ensuring compliance with state and federal regulations.

The role requires CPC or CCS certification, at least 3 years of relevant experience, and familiarity with HIPAA privacy standards. Responsibilities include supporting multiple departments, generating reports, and