Coding Analyst I

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.

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:

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. 

$29.66 - $46.72

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.

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.