Coding Analyst II

Medica•,

1d•$45,900 - $78,600•Remote

About The Position

The Coding Analyst II performs high-level coding, audit, and analysis activities that ensure accurate application of medical coding standards within claims, reimbursement, and operational workflows. This role interprets clinical documentation, applies established coding guidelines, and identifies discrepancies that impact claims accuracy, provider reimbursement, or regulatory compliance. It works with minimal supervision on moderately complex cases, serves as a resource to peers, and contributes to coding quality improvement efforts. The analyst also supports cross-functional partners by offering coding expertise that strengthens data integrity, payment accuracy, and operational consistency. Performs other duties as assigned.

Requirements

Bachelor's degree in Health Information Management, Healthcare Administration, Business, or a related field, or equivalent combination of education and experience
3+ years of work experience beyond degree in coding for health plan, insurance payer, facility and/or hospital
Coding certification required (CCA, CPC-P, CPC, CPC-H, CCS, CCS-P, RHIT, RHIA)
Must have a primary home address located within any state where Medica is registered as an employer - AR, AZ, FL, GA, IA, IL, KS, KY, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, WI
Must be legally authorized to work in the United States at the time of application.

Nice To Haves

Demonstrated knowledge of revenue codes, National Uniform Billing Committee (NUBC) guidelines, UB-04 claim requirements, DRGs, and facility reimbursement methodologies
Experience analyzing medical coding and claim data to determine appropriate coding, payment, and reimbursement outcomes
Strong understanding of how coding impacts claim adjudication, provider reimbursement, and payment accuracy
Experience researching and interpreting coding guidelines, industry standards, and healthcare billing requirements
Proven analytical and problem-solving skills with the ability to investigate coding issues and identify root causes
Ability to track trends, identify process improvement opportunities, and recommend upstream solutions to reduce rework and adjustments
Strong written and verbal communication skills with the ability to explain coding decisions and rationale to internal stakeholders

Responsibilities

Review and code clinical documentation using ICD, CPT, HCPCS, and internal coding guidelines.
Validate coding accuracy to support compliant billing, reimbursement, and data reporting.
Research missing or unclear information to ensure proper code assignment.
Complete timely coding reviews that enable accurate claims processing.
Perform audits of claims, encounters, and documentation to detect coding errors or inconsistencies.
Analyze coding patterns to identify trends, risks, or gaps affecting payment accuracy.
Document findings clearly and recommend corrective actions that reduce recurrence.
Communicate audit results to internal partners, ensuring clarity, professionalism, and follow-through.
Investigate coding impacts on claims adjudication, reimbursement, and provider disputes.
Collaborate with configuration, operations, and provider teams to resolve issues efficiently.
Verify coding rules within system logic and flag discrepancies for correction.
Support issue triage workflows that improve operational stability and payment accuracy.
Apply coding regulations, payer guidelines, and organizational policies consistently.
Maintain compliance with regulatory requirements, audit standards, and documentation expectations.
Participate in coding quality initiatives that strengthen accuracy and reduce rework.
Monitor updates to coding rules and support implementation of required changes.
Provide guidance to junior analysts on coding practices, documentation requirements, and audit methods.
Assist with training, documentation updates, and knowledge-sharing within the team.
Participate in process improvement efforts that enhance coding workflows and accuracy.
Contribute to team goals by delivering reliable expertise, consistent quality, and timely work.