Senior Analyst, Pre-Pay Dispute Coding (Remote)

Job Summary

Provides lead level expertise in the resolution of complex provider denial disputes and state complaint cases ensuring the claims adhere to correct billing standards and regulations.

Job Duties

•  Investigates and resolves escalated provider denial dispute cases that require advanced experience and specialized knowledge. Addresses and resolves state complaint cases related to escalated provider denial disputes.
• Provides assistance to dispute coders by responding to inquiries accurately and in a timely manner.
• Prepares and summarizes trends identified by dispute coders for review by team leadership.
• Investigates and resolves escalated dispute cases that require additional experience and expertise.
• Identifies and communicates any coding errors or inconsistencies, collaborating with appropriate internal department(s) when necessary, capturing and tracking issues to ensure accurate code editing.
• Supports ongoing dispute process improvements and informs leadership of any identified issues.

Job Qualifications

REQUIRED QUALIFICATIONS:

• Minimum of 4 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.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.