Job Description:
The Coding Analyst I for SelectHealth provides general expertise in coding for highly-regulated, government insurance programs such as Medicare, Medicaid, Affordable Care Act (ACA), Children's Health Insurance Program (CHIP), Federal Employees Health Benefit (FEHB) program, and self-funded plans. This analyst reviews claims and appeals and tracks provider appeals including sending correspondence to providers.
This position is responsible for the following:
- Reviewing claims to monitor billing practices and ensure accurate coding and reimbursement based on specific contracts, payment methodologies and state and federal regulations.
- Ensuring review decisions are in line with Employee Retirement Income Security Act (ERISA) standards.
- Tracking provider appeals and sending correspondence to providers on submitted appeals.
- Serving as a consultant to various departments within SelectHealth and Intermountain Healthcare, requiring one-on-one engagement and communication with physicians and offices. Supporting higher level analysts in their responsibilities and research.
- Supporting all internal departmental functions and processes.
- Maintaining subject-matter expertise and educating providers and staff accordingly.
- Ensuring compliance with all coding regulations for all provider specialties and coding methodologies.
- Managing compliance with state and federal regulations that vary by state and line of business.
This role is Remote, though candidates need to be in the Murray, Utah area. Flexible schedule Monday - Friday during business hours.
Minimum Qualifications:
- Associate degree from an accredited institution (education will be verified).
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- Two years of work experience in coding, healthcare, or in a health plan environment.
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- Demonstrated Intermediate level experience with Microsoft Office applications.
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- Demonstrated excellent written and verbal communication and presentation skills.
Preferred Qualifications:
- Bachelor's Degree from an accredited institution (education will be verified).
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- National professional coding certification (e.g., Certified Professional Coder (CPC), Certified Coding Specialist (CCS)). Must be obtained within one year of hire.
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- Two years of coding or auditing experience in a professional, facility, or health plan environment.
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- Excellent organizational, analytical, and communication skills.
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- Demonstrated ability to establish and maintain rapport with co-workers, physicians, and other health care providers.
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- Demonstrated ability to perform tasks independently and with minimal supervision.
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- Demonstrated sound judgment and decision-making skills.
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- Experience with Government programs (Medicare, Medicaid, or ACA).
Physical Requirements:
Interact with others requiring the employee to communicate information. Operate computers and other equipment requiring the ability to move fingers and hands. See and read computer monitors and documents. Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.
Location: SelectHealth - Murray
Work City: Murray
Work State: Utah
Scheduled Weekly Hours: 40
The hourly range for this position is $29.66 - $46.72, dependent upon experience.
We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness.
Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers, and for our Colorado, Montana, and Kansas based caregivers; and our commitment to diversity, equity, and inclusion.
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
All positions subject to close without notice.
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