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Gravie

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Clinical Operations Analyst, Medical Coding

Clinical OperationsClinical OperationsFull TimeRemoteSeniorTeam 51-200H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

24 days ago

Salary

$71.8K - $95.7K / year

Seniority

Senior

Bachelor Degree5 yrs expEnglish

Job Description

Clinical Operations Analyst, Medical Coding

Gravie

• Support the design and implementation of clinical protocols, SOPs, and medical policies. • Analyze medical records and plan design language for accurate code assignments and compliance. • Evaluate treatment plans and audit large claims to identify discrepancies. • Partner with underwriting and stop-loss teams for coding insights and risk assessments. • Support clinical operations in managing and analyzing clinical program data. • Act as a trusted advisor across the organization, providing guidance and training regarding coding practices and clinical standards.

Job Requirements

  • Successful completion of a medical coding certification program.
  • Bachelor’s degree in Nursing, Health Information Management, or a related education.
  • 5+ years of medical coding experience and 2+ years in a health plan, TPA, or managed care organization.
  • Expert knowledge of anatomy, medical terminology, and coding systems, including experience with coding software and EHRs.
  • Demonstrated ability to analyze data, identify trends, and support decision-making related to fraud, waste, and abuse, with the ability to exercise independent judgment.

Benefits

  • Alternative medicine coverage
  • Generous PTO
  • Up to 16 weeks paid parental leave
  • Paid holidays
  • 401k program
  • Transportation perks
  • Education reimbursement
  • Paid paw-ternity leave

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