SIU Medical – Behavioral Health Coding Analyst

This is a fully remote position, open to applicants in Alabama, +31 more locations.

📋 Description

• Perform thorough reviews of medical records to ensure CPT/HCPCS/Revenue codes and modifiers align with documentation.

• Deliver comprehensive written summaries detailing the findings from medical record reviews.

• Communicate findings effectively to investigators, leadership, law enforcement, legal representatives, providers, and state regulators.

• Investigate and implement state or CMS guidelines as necessary.

• Collaborate with Medical Directors to review and discuss cases.

• Support investigative research regarding coding inquiries and state and federal regulations.

• Detect potential billing discrepancies, abuse, and fraudulent activities.

• Highlight potential savings opportunities during prepayment reviews.

• Maintain accurate records, files, and documentation.

• Adhere to departmental workflows and achieve daily performance goals.

• Stay updated on coding knowledge related to compliance and reimbursement changes.

⛳️ Requirements

• Certification as an AAPC Certified Professional Coder (CPC).

• At least 3 years of experience in medical and/or behavioral health professional coding.

• A minimum of 1–2 years of recent professional coding experience, encompassing medical record review and documentation auditing.

• Proficient knowledge of CPT, HCPCS, and Revenue Codes.

• Familiarity with CMS 1500 and UB04 data elements.

• Capability to interpret and consistently apply coding policies and guidelines.

• Proficient in Microsoft products, including Excel and Word.

• Willingness to travel for job requirements, if necessary.

• Possession of a GED or High School diploma.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to base salary.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources to support physical, emotional, and financial well-being.