Coding Analyst I-SelectHealth

About this role

• Fully Remote SelectHealth - Murray Full time R186886 Job Description: The Coding Analyst I for SelectHealth provides general expertise in the areas of all areas of coding (professional, facility (inpatient and outpatient), drug, Durable Medical Equipment (DME), and lab code sets) 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 with unique plan designs, reimbursement, compliance initiatives, regulatory legislation, and billing practices.
• This analyst reviews claims and monitors provider appeals including sending correspondence to providers.
• We are committed to offering flexible work options where approved and stated in the job posting.
• However, we are currently not considering candidates who reside or plan to reside in the following states: California, Connecticut, Hawaii, Illinois, Maine, Massachusetts, Minnesota, New York, Pennsylvania, Rhode Island, Virginia, Vermont, Washington.
• Please note that a video interview through Microsoft Teams will be required as well as potential onsite interviews and meetings Essential Functions Reviewing claims (pre-payment) to monitor billing practices and ensure accurate coding and reimbursement based on specific contracts, payment methodologies and state and federal regulations that vary by geography and lines of business Ensures review decisions are in line with Employee Retirement Income Security Act (ERISA) standards.
• Logging provider appeals and sends correspondence to providers on submitted appeals.
• Serving as a consultant to various other departments within Select Health and departments within Intermountain Healthcare including physicians and facilities.
• Does require one on one physician and/or office engagement and communication and training.
• Supporting higher level analysts in their responsibilities and research.
• Maintaining subject-matter expertise and educates providers and staff accordingly.
• Responsible for compliance with all coding regulations for all provider specialties (surgical and non-surgical) and coding methodologies (including inpatient (Non DRG and DRG), outpatient (APC and non- APC), Ambulatory Surgical Centers (ASC), drugs and biologicals, lab and genetics, home health, DME and any other type of claim we may receive.
• Responsible for compliance with all regulations: State and federal regulations vary by state and line of business.
• Skills Medical Billing and Coding Claims Processing Customer Service Critical Thinking Documentation Time Management Communication Verbal and Written Attention to Detail ICD Coding Electronic Medical Records (EMR) Qualifications Minimum Qualifications Associate degree from an accredited institution.
• Education will be verified -or - Two years of work experience in coding, healthcare, or in a health plan environment.
• -and - Demonstrated Intermediate level experience with Microsoft Office applications.
• Demonstrated excellent written and verbal communication and presentation skills.
• Preferred Qualifications Bachelor's Degree from an accredited institution.
• 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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