Remote Healthcare Coding & Cost Analyst I

Geisinger; Pennsylvania; Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Healthcare benefits

Vision and dental

Domestic partner benefits

Job summary

Geisinger is seeking a Certified Medical Coder to perform thorough reviews of billed services, authorizations, plan benefit documents, and medical records to guide reimbursement. The role supports multiple departments and requires adherence to HIPAA and contractual guidelines.

The position is work-from-home, with a secure home office setup and guidance from the Health Plan coding team. A CPC or CCS certification is required with 3+ years of experience.

Qualifications

• High school diploma or GED required; specialty training preferred.
• Minimum 3 years relevant experience; 2 years clinical experience preferred.
• CPC-Certified Professional Coder (AAPC) or CCS-Certified Coding Specialist (AHIMA) required.

Responsibilities

• Review and recommend correct coding and reimbursement for claims.
• Conduct clinical reviews related to Claims, Edits, Appeals and Grievances.
• Validate pended and reconsidered claims per plan edits and CMS guidelines.
• Create and maintain reports to track department data.
• Assist onboarding of new team members and participate in ad hoc workgroups.

Skills

Computer literacy

Critical thinking

Organizing

Education

High School Diploma or GED

Specialty Training Program

Job description

Geisinger is seeking a Certified Medical Coder to perform thorough reviews of billed services, authorizations, plan benefit documents, and medical records to guide reimbursement. The role supports multiple departments and requires adherence to HIPAA and contractual guidelines.

The position is work-from-home, with a secure home office setup and guidance from the Health Plan coding team. A CPC or CCS certification is required with 3+ years of experience.