Defence Global Product Cost Analyst
Rolls-RoyceImprove defense engine cost data, reporting, and forecasts at Rolls-Royce. Support global programs, supply chain, and finance teams with product cost decisions.
Open
Geisinger is a Pennsylvania-based healthcare organization serving local communities through accessible medical services and innovative patient care. Founded in 1915, the organization hires across nursing, allied health, administration, and other healthcare functions, with a focus on professional development and a workplace that values diversity, equity, and inclusion.
Coding and Cost Analyst I
Review Geisinger Health Plan claims, coding, and reimbursement, and recommend potential recoveries. Validate high-dollar claim payments against healthcare regulations and plan contracts.
Description
- Review billed services, authorizations, benefit documents, itemized statements, medical records, discharge summaries, and detailed reports.
- Recommend reimbursement or recovery based on coding, billing data, policies, industry standards, contracts, and applicable regulations.
- Advise Health Plan departments on accurate coding, billing, and reimbursement.
- Conduct clinical reviews for claims, claim edits, appeals, and grievances.
- Help assess clinical risk for Underwriting, Pharmacy, and Finance.
- Recommend recoveries in line with contracts, policies, procedures, and industry standards.
- Review and validate pended and reconsidered claims using CPT, industry, and CMS guidelines.
- Review high-dollar inpatient and outpatient claims and support quality concern reviews.
- Validate claim payments against plan contracts in coordination with Pharmacy and PNM departments.
- Create and maintain departmental tracking reports.
- Join discussions about complex medical reviews.
- Help onboard new team members.
- Participate in assigned workgroups and committees.
Requirements
- High school diploma or GED required.
- AAPC Certified Professional Coder (CPC) or AHIMA Certified Coding Specialist (CCS) credential required.
- At least three years of relevant experience required.
- Relevant experience may include related work and completed specialty training.
- One year of specialty training counts as one year of relevant experience.
- LPN credential preferred.
- At least two years of clinical experience preferred.
- Computer literacy.
- Critical thinking skills.
- Organizational skills.
- A secure home office that meets HIPAA Privacy standards.
- Ability to follow organizational policies and procedures.
Benefits
- Healthcare coverage for full-time and part-time employees starting on day one.
- Vision coverage.
- Dental coverage.
- Domestic partner benefits.
- Work-from-home arrangement.
- Occasional onsite department meetings as needed.
Related Jobs
Spend Analyst, Hospital Pharmacy Savings
BluesightSupport Bluesight’s CostCheck platform in helping hospitals recover pharmacy savings. Manage customer engagement, monitor performance, and collaborate on improvements across healthcare systems.
Open
Ambulatory Coding Analyst
Franciscan HealthReview ambulatory provider documentation and CPT coding for accuracy and billing compliance. Share audit findings, reports, and coding guidance with Franciscan Health physicians.
Open
Analyst I, Falcon Complete Cybersecurity
CrowdStrikeInvestigate and respond to security threats for CrowdStrike’s virtual security operations center. Handle incidents across endpoint, identity, email, and cloud environments.
Open
Healthcare Quality Outreach Coordinator Analyst at CVS Health (Hybrid, US)
CVS HealthSupport Aetna Better Health of Louisiana’s quality and population health work through member outreach, performance analysis, and education. Help improve care quality, HEDIS results, and member outcomes.
Open