Med Coding Appeals Analyst (US)

A Med Coding Appeals Analyst at Elevance Health ensures accurate adjudication of claims by translating medical, reimbursement, and clinical editing policies into effective criteria. The role involves reviewing medical documentation for Evaluation and Management, CPT, HCPCS, and ICD-10 codes while analyzing legislative mandates to develop enterprise reimbursement policies. Analysts perform pre-adjudication claim reviews, coordinate research for system inquiries, and train staff on coding issues and system edits.