CODING ANALYST RESUME EXAMPLE
Published: July 23, 2024 - The Coding Analyst meticulously reviews claim and medical documentation to ensure accurate payment validation and manages the claim appeal process. This role involves conducting detailed reviews, reporting on audit outcomes, and analyzing trends through AudaPro to enhance team education and training. Additionally, the analyst remains proactive in updating coding practices based on Medicare regulations, engages in continuous learning activities, and communicates effectively with providers to clarify documentation as needed.
Tips for Coding Analyst Skills and Responsibilities on a Resume
1. Coding Analyst, Health Solutions Inc., Miami, FL
- Review claim and medical record documentation to validate improper payments
- Determines claim appeal process as appropriate
- Supervises all published reviews by Noridian
- Performs focused reviews and provides results to the team
- Inputs all governmental reviews in AudaPro, including audit outcomes
- Runs AudaPro reports to analyze trends and utilizes results to recommend appropriate education and/or training
- Ensures audit timelines for all audit types are followed accordingly
- Communicate with providers to acquire documentation clarification
- Performs charge corrections via the CSLink billing system as appropriate
- Researches coding issues that arise and reports areas of risk
- Supervises Medicare rules for updates and changes
- Assists in preparing audit reports as vital
- Participates in meetings, training, and conference calls
- Participates in workshops, seminars, audio conferences and other informative opportunities to ensure continued learning for self-improvement
Skills on Resume:
- Claims Review and Analysis (Hard Skills)
- Audit Management (Hard Skills)
- Data Analysis and Reporting (Hard Skills)
- Communication Skills (Soft Skills)
- Regulatory Knowledge (Hard Skills)
- Technical Proficiency (Hard Skills)
- Training and Education (Soft Skills)
- Problem-Solving (Soft Skills)
2. Coding Analyst, Precision Coding Services, Dallas, TX
Job Summary:
- Oversee the preliminary analysis of Investment Management Agreements, Investment Guidelines, Prospectus and any other supporting documents
- Oversee the implementation of new or amended compliance rules in Aladdin to support investment guideline requirements
- Ensure processes, documentation, and rule testing and implementation are completed in a timely and robust manner and in accordance with documented processes and procedures
- Assist the BAU Mandate monitoring team with queries with respect of investment guidelines and coded rules
- Act as the primary point of contact for the Investments teams and Client Services in respect of new and existing client and regulatory mandates
- Development of good working relationships with FM’s, PMA’s, Client Services, IT, BRS and Data Management Teams to ensure the Mandate Compliance Team performs its obligations fully and professionally
- Work with CMIA colleagues to ensure consistency and alignment where possible
- Assist the Mandate Coding Team Leader with the ad hoc projects
- Utilizes clinical and coding knowledge to ensure accurate and compliant charge items and to recognize and resolve billing inconsistencies.
- Utilizes clinical and ICD coding knowledge to ensure accurate and compliant diagnoses and to recognize and resolve diagnostic coding inconsistencies.
- Develops and maintains a compliance resource library.
- Coordinates audits to improve processes related to revenue cycle, efficiency of charging and billing, and collection efforts.
- Conducts compliance research.
Skills on Resume:
- Investment Compliance Management (Hard Skills)
- System Implementation and Testing (Hard Skills)
- Process Documentation and Review (Hard Skills)
- Stakeholder Communication and Coordination (Soft Skills)
- Mandate Compliance (Hard Skills)
- Clinical and Coding Knowledge (Hard Skills)
- Audit Coordination and Process Improvement (Hard Skills)
- Compliance Research and Resource Development (Hard Skills)
3. Coding Analyst, Medical Records Corp., Atlanta, GA
Job Summary:
- Providing clinical content support to 3M HIS end-user products by applying Natural Language Processing (NLP) and Natural Language Understanding (NLU) in a clinical setting.
- Reviewing customer-facing software to determine NLP accuracy.
- Editing NLU rules to improve accuracy.
- Testing changes against data, validating improvements to the products and supporting the release of changes to customers (gold standard corpus creation).
- Identifying relevant clinical data from electronic health record (EHR) documents.
- Supporting informatics and technical requirements for continuous improvement to the design and content of 3M clinical products.
- Use clinical and coding expertise to analyze medical records and charts in relation to provider coding.
- Identify physician practices with complex coding patterns and report relevant data to the Centers for Medicare and Medicaid Services (CMS).
- Analyze necessary documentation, including medical records/charts
- Apply clinical coding expertise to evaluate the appropriateness of provider coding and report relevant data to the Centers for Medicare and Medicaid Services (CMS).
- Analyzes content of system-generated reports and software edits to facilitate revisions with appropriate clinical departments.
- Works with management and intradepartmental employees to improve and optimize billing and coding practices.
Skills on Resume:
- Clinical Data Analysis (Hard Skills)
- Clinical Coding and Compliance (Hard Skills)
- Software Testing and Validation (Hard Skills)
- Informatic and Technical Support (Hard Skills)
- Data Analysis and Reporting (Hard Skills)
- Cross-Functional Collaboration (Soft Skills)
- Regulatory Reporting (Hard Skills)