Proclinical is seeking a Policy Coding & Enforcement Analyst to join our team remotely. This position requires clinical expertise and familiarity with laboratory billing practices. Occasional travel (one week per month) is required for staff training and team-building activities.
Primary Responsibilities:
The successful candidate will focus on coding analysis, claim editing, and enforcement rule development within the healthcare and dermatology space.
Skills & Requirements:
- Clinical experience, particularly in laboratory coding.
- Certification such as RHIT, CPC, CCS, or similar is preferred.
- Strong understanding of coding principles and healthcare reimbursement practices.
- Familiarity with government healthcare programs (e.g., Medicare, Medicaid).
- Detail-oriented with excellent documentation skills.
- Ability to work collaboratively in a remote setting.
The Policy Coding & Enforcement Analyst's responsibilities will be:
- Develop and enforce claim editing rules.
- Configure, build, and test edits for claims processing.
- Apply clinical knowledge of ICD-10, CPT, and HCPCS coding principles.
- Ensure accurate documentation and maintain high attention to detail.
- Support laboratory billing and reimbursement processes.
- Collaborate with teams to ensure compliance with government programs such as Medicare and Medicaid.
- Participate in monthly travel for training and team-building purposes.
Compensation:
- $65 000.00 - $75 000.00 Per Annum
If you are having difficulty in applying or if you have any questions, please contact George Watson at g.watson@proclinical.com
If you are interested in applying to this exciting opportunity, then please click 'Apply' or to speak to one of our specialists please request a call back at the top of this page.
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