Contract Biller/Coder – Claims Analyst
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About Vital Incite
Vital Incite helps employers and plan sponsors improve healthcare oversight through data-driven insights, payment integrity, and proactive claims monitoring.
Position Summary
Vital Incite is seeking a Contract Biller/Coder – Claims Analyst to support ongoing review of medical and pharmacy claims for coding accuracy, reimbursement appropriateness, and outlier activity. This role also helps develop and maintain claim alert and trigger criteria to identify high-risk patterns and support proactive oversight efforts.
Key Responsibilities
- Review medical and pharmacy claims for coding accuracy and payment appropriateness
- Identify potential coding errors, modifier misuse, and unusual reimbursement patterns
- Document findings clearly to support follow-up and recovery efforts
- Develop and refine claim triggers and alert criteria for high-risk or outlier claims
- Perform quality checks on trigger results to improve accuracy and reduce false positives
- Collaborate with internal claims and clinical teams to support actionable insights
Qualifications
- 3+ years of experience in medical billing, coding, or claims review
- Strong knowledge of CPT, HCPCS, ICD-10, modifiers, and reimbursement methodologies
- Ability to identify patterns and anomalies in claims data
- Strong written communication and documentation skills
- Active coding credential preferred (CPC, CCS, CCS-P, RHIA, RHIT, or equivalent)
- Experience with payment integrity, audits, or overpayment recovery is a plus
Work Details
- Contract (1099) position
- Part-time, approximately 5–8 hours per week
- Flexible schedule
- Remote, U.S.-based preferred
Vital Incite helps employers and plan sponsors improve healthcare oversight through data-driven insights, payment integrity, and proactive claims monitoring.
Vital Incite is seeking a Contract Biller/Coder – Claims Analyst to support ongoing review of medical and pharmacy claims for coding accuracy, reimbursement appropriateness, and outlier activity. This role also helps develop and maintain claim alert and trigger criteria to identify high-risk patterns and support proactive oversight efforts.