Claims Coding Analyst
HealthfirstFlorida, United States • New York, New York, United States
Posted January 14, 2026
61800 - 91120 USD
Full Time
About the Company
Healthfirst believes that every New Yorker deserves access to the best available healthcare. As one of New York’s highest quality not-for-profit health insurers serving close to two million New Yorkers, we make this a reality for our members. Founded more than 30 years ago by the leading hospital systems in downstate New York, Healthfirst established a partnership model that enables hospitals, health systems, and physicians in our network to prioritize health outcomes over profits, placing the needs of our members and community first. Healthfirst serves members in New York City, on Long Island, and in Westchester, Rockland, Sullivan, and Orange counties, offering market-leading products to suit every life stage. Our offerings include Medicaid plans, Medicare Advantage plans, Child Health Plus plans, Essential Plans, Long-Term Care plans, and Qualified Health plans. For more information on Healthfirst, please visit healthfirst.org.
Job Description
The Claims Coding Analyst is responsible for making coding-based decisions on claims and appeals to maintain and enhance Healthfirst's claims editing systems. The role requires independent judgement and involves setting Healthfirst claims policy and ensuring alignment with CMS, NY State Department of Health, and CPT, HCPCS, and ICD-10 coding guidelines. The position requires three days per week in office at either Lake Mary, FL or New York, NY, and involves conducting assessments of current claims edits, identifying areas of opportunity, and leading implementation efforts.
Requirements
- Coding certification from American Academy of Professional Coders (AAPC), Certified Professional Coders (CPC), or American Health Information Management Association (AHIMA)
- High school diploma or GED from an accredited institution
- Previous relevant experience
- Bachelor's degree in a related field
- Time management, critical/creative thinking, communication, and problem-solving skills
- Demonstrated professional writing, electronic documentation, and assessment skills
- Intermediate Outlook, Basic Word, Excel, PowerPoint, Adobe Acrobat skills
- Knowledge of anatomy and pathophysiology medical terminologies
Benefits
- Medical, dental, and vision coverage
- Incentive and recognition programs
- Life insurance
- 401k contributions
