Healthcare & Medical Coding Analyst

/Healthcare & Medical Coding Analyst

Healthcare & Medical Coding Analyst



The Healthcare & Medical Coding Analyst supports the Data Science & Innovation department by playing a strategic role in the development of valuable clinical insights for our members.  Qualified candidates will contribute to the design and implementation of algorithms to discover valuable information hidden within large volumes of data from various sources.  These discoveries will be led by both your clinical background and your knowledge of diagnostic and procedural codes to see and abstract trends and patterns in data.  Candidate will utilize procured data to understand the specific health needs of populations or diagnoses and leverages the data to assist the data science team in developing methods to improve outcomes and increase ROI. This position requires business acumen, coding skills and clinical understanding to perform daily tasks.


  • Work closely with the Data Science and Innovation team as a healthcare coder/data SME related to mapping and claims data analysis work
  • Map/assign diagnostic and procedural codes to medical conditions and to medical specialties in the development of algorithms for software development
  • Maintain and update ICD-10, ICD-9, PCS and CPT codes used in algorithms
  • Maintain data integrity related to diagnostic and procedure codes
  • Abstract pertinent information related to healthcare codes for new product development
  • Pull and integrate data from disparate sources (e.g. cost and claims and clinical data)
  • Evaluate and preprocess raw information
  • Delve into data to discover discrepancies and patterns
  • Assist with clinical evaluation and ROI modeling
  • Assist with strategy and planning of the various data science initiatives as they relate to product development
  • Quality Assurance of data extractions leveraging ICD-10, PCS and CPT codes
  • Create and validate record-keeping processes


  • Bachelor or master’s degree in related field.


  • Registered Health Information Administrator- (RHIA) or proven experience with and knowledge of medical coding and associated healthcare data analysis
  • Proficiency in ICD-10-CM, PCS and CPT procedure codes across medical and surgical domains for inpatient, outpatient and healthcare visits
  • At least 5 years current ICD-9, DRG, CPT inpatient, outpatient coding required
  • In-depth knowledge of coding, data abstracting & reporting
  • Experience with database design and querying
  • Experience with automated encoder, abstract database and Microsoft office
  • Understand health care operations and systems
  • Experience in interactive analysis for multidimensional views of data
  • Coding supervisory experience preferred
  • Good communication skills
  • Intermediate level of proficiency in Microsoft Office programs

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2018-06-13T12:20:08+00:00 May 31st, 2018|Comments Off on Healthcare & Medical Coding Analyst