Senior Claims Coding Analyst

Healthfirst

. Serve as a triage coordinator for provider disputes and determine appropriate resolution pathways .

Posted 9/15/2026full-timeRemote • Connecticut • United StatesSenior💰 $73,400 - $120,360 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in coding analysis, dispute resolution, and claims management, with a strong focus on improving operational efficiency and reducing administrative costs. Proficient in applying coding guidelines and collaborating with cross-functional teams to enhance provider education and workflow processes.

Highest-signal resume keywords

CPC CertificationClaims Payment ExperienceCoding AnalysisProvider Disputes ManagementHealthcare Operations Analytics

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Coding AnalysisClaims EditingClaims ConfigurationCPT KnowledgeHCPCS KnowledgeICD-10 KnowledgeCMS KnowledgeMedical TerminologyAnatomy KnowledgeDispute Resolution

Soft Skills

CommunicationMentorshipAnalytical ThinkingProblem SolvingCollaboration

Certifications & Qualifications

CPC CertificationAAPC CertificationAHIMA Certification

Industry Keywords

Claims OperationsProvider EducationPayment PoliciesDispute Volume MonitoringAdministrative Cost Reduction

About the role

Key responsibilities & impact

Serve as a triage coordinator for provider disputes and determine appropriate resolution pathways
Analyze dispute populations to identify trends, root causes, and lower-cost resolution opportunities
Perform independent coding analysis and disposition complex claims, disputes, and appeals
Identify high-volume and high-cost dispute scenarios and develop population-level solutions
Recommend and support changes to claims edits, configuration, payment policies, workflows, automation, and provider education
Partner with Claims, Provider Operations, Configuration, Technology, Payment Integrity, and other stakeholders
Monitor dispute volume, overturn and repeat rates, turnaround time, administrative cost, and resolution outcomes
Serve as a coding and payment policy subject matter expert
Review medical records as needed to determine appropriate coding and claim disposition
Communicate coding and payment decisions to providers and internal stakeholders
Lead continuous improvement efforts to reduce avoidable disputes and administrative expense
Provide day-to-day guidance and mentorship to Claims Coding Analysts
Perform additional duties and special projects as assigned

Requirements

What you’ll need

Coding class completion and/or certification from AAPC or AHIMA, including CPC or equivalent
Previous professional coding and/or claims payment experience on both payer and provider side
Experience researching and applying coding guidelines to complex claims or provider disputes
Ability to independently analyze claims and disputes and make defensible coding and payment decisions
High school diploma or GED from an accredited institution
Bachelor’s degree in a related field preferred
Experience with provider disputes, claims operations, claims editing, claims configuration, or healthcare operations analytics preferred
Knowledge of anatomy, medical terminology, CPT, HCPCS, ICD-10, CMS, and New York State coding and payment requirements preferred

Benefits

Comp & perks

Medical, dental and vision coverage
Incentive and recognition programs
Life insurance
401k contributions
Competitive compensation and benefits package