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Coding Analyst Lead - Miami, F...


Job Summary

Miami, FL
Other/Not Classified
Job Type
Full Time
Career Level
Experienced (Non-Manager)
Job Reference Code

Coding Analyst Lead - Miami, FL, Tampa, FL, or Work from Home in the state of Florida - PS4582

About the Job


Your Talent. Our Vision. At Simply Healthcare, a proud member of the Anthem, Inc. family of companies, it's a powerful combination and the foundation upon which we're creating greater care for our members, greater value for our customers, and greater health for our communities. We are a Florida licensed health maintenance organization that serves individuals enrolled in Medicaid and/or Medicare programs, Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve.

Location: Miami, FL, Tampa FL, or Work from Home in the state of Florida.

The Coding Analyst Lead is responsible for leading a team that reviews, audits, and codes medical records for the purpose of reimbursement, training, education and compliance.

Primary duties may include, but are not limited to:

  • Audits and reviews medical documentation for appropriate ICD-10 and CPT coding and documentation.
  • Queries physicians when code assignments are not straightforward or documentation is unclear.
  • Trains and educates team on coding, documentation, claim payment guidelines, and related issues.
  • Reviews CPT and ICD-10 codes annually for accuracy and implements changes, including charge ticket update by specialty.
  • Stays current on coding guidelines and reimbursement reporting requirements.
  • Educates and trains providers on documentation and coding.
  • Requires a high school diploma; 2 years of experience; or any combination of education and experience, which would provide an equivalent background
  • Certified Medical Coder (CPC or CCS-P) required
  • Knowledge of medical terminology and anatomy required
  • Ability to prepare and present presentations and work in a workgroup required
  • Strong MS Excel skills required
  • FACETS experience preferred
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.

* The language below is approved boilerplate, so you can integrate part or all of it in job descriptions.

Simply Healthcare Plans is a Florida managed health care provider that serves Medicare and Medicaid members. Through our Clear Health Alliance organization, our health plan also serves Floridians who are eligible for HIV/AIDS Medicaid specialty health plan services. Along with our sister plan, Amerigroup Florida, we serve more than 600,000 Floridians who are members of our Medicare and Medicaid plans. Across the nation, our family of health plans serves nearly 40 million members, and 1 in 8 Americans is served by our family of companies. Our health plan members are assured care that is not only accessible, but also accountable, comprehensive, integrated and patient-centered. Each and every day, members of our team can be found in Florida communities, listening to our members, interacting with our health care providers and partnering with community-based organizations to execute health education initiatives. Our goal is to ensure members and entire communities are empowered to become active participants in their health care and sustain healthy lifestyles. To learn more about Simply Healthcare Plans, visit www.simplyhealthcareplans.com.


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