Coding Analyst I-SelectHealth

61000 SelectHealth Inc; Murray (UT); Hybride; USD 43 000 - 67 000; Plein temps

Résumé du poste

Intermountain Health's Select Health in Murray, Utah seeks a Coding Analyst I to provide expertise across professional, facility, drug, DME, and lab coding for government programs. Review claims, monitor reimbursement, handle appeals, and train providers while collaborating with physicians and Intermountain departments.

Flexible work options are available where approved. Qualifications include an associate degree or 2 years in coding/health plan, strong Microsoft Office skills, and excellent

Qualifications

• Associate degree or 2 years of coding/health plan experience.
• Proficiency with Microsoft Office applications.
• Excellent written and verbal communication and presentation skills.

Responsabilités

• Review claims pre-payment to monitor coding and reimbursement.
• Ensure decisions align with ERISA standards.
• Log provider appeals and communicate with providers on appeals.
• Serve as a consultant to Intermountain Health and Select Health departments.
• Engage with physicians and staff for training.
• Support higher level analysts and manage workload.
• Maintain subject-matter expertise across coding regulations.
• Ensure compliance with coding regulations across all provider specialties.

Connaissances

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

Formation

Associate degree

Bachelor's Degree

National coding certification (CPC/CCS)

Outils

Microsoft Office

Description du poste

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.

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.


• Effectively managing workload and responsibilities.


• 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. Education will be verified. National professional coding certification (e.g., Certified Professional Coder (CPC), Certified Coding Specialist (CCS)). Must be obtained within one year of hire. Two years of coding or auditing experience in a professional, facility, or health plan environment. Excellent organizational, analytical, and communication skills. Demonstrated ability to establish and maintain rapport with co-workers, physicians, and other health care providers. Demonstrated ability to perform tasks independently and with minimal supervision. Demonstrated sound judgment and decision-making skills. Experience with Government programs (Medicare, Medicaid, or ACA).

Physical Requirements

Ongoing need for employee to see and read information, documents, monitors, identify equipment and supplies, and be able to assess customer needs. Frequent interactions with providers, colleagues, customers, and members that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately. Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc. 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 listed below. Actual hourly rate dependent upon experience. $31.01 - $48.84

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 that encompasses living healthy, happy, secure, connected, and engaged. Learn more about our comprehensive benefits package here.

By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations.

If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.

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.

At Intermountain Health, we use the artificial intelligence (\"AI\") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment.

All positions subject to close without notice.

Headquartered in Utah with locations in six primary states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 34 hospitals, 400+ clinics, a medical group of more than 4,800 employed physicians and advanced care providers, a health plan division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery.

Intermountain Health’s PEAK program supports caregivers in the pursuit of their education goals and career aspirations by providing up-front tuition coverage paid directly to the academic institution. The program offers 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates. Caregivers are eligible to participate in PEAK on day 1 of employment. Learn more.

The primary intent of this job description is to set a fair and equitable rate of pay for this classification. Only those key duties necessary for proper job evaluation and/or labor market analysis have been included. Other duties may be assigned by the supervisor.

All positions subject to close without notice. Thanks for your interest in continuing your career with our team!