Clinical Analyst Appeals (Remote)

Job Summary

Required Qualifications

• •CCS and/or CDIP
• •Associate degree preferably in the business, healthcare, or finance field
• •Minimum of two (2) to three (3) years auditing and familiarity with CPT/HCPCs/DRG coding experience
• •Minimum 2 years of healthcare revenue cycle experience
• •Sound understanding of ICD-10, and CPT coding systems; prospective reimbursement system
• •Ability to review and analyze issues related to coding, billing, and medical record documentation
• •Excellent interpersonal and communication skills to positively interact with a variety of hospital personnel, including administrative and management staff
• •Highly skilled experience and knowledge of Windows-based software required, including but not limited to Microsoft Windows, Outlook, Excel, and Access
• •Possess effective oral and written skills, including superb formal presentation skills
• •Well-developed research skills
• •Excellent organizational and project management skills
• •Effective time management skills to permit handling of large workloads
• •A thorough understanding and knowledge of Medicare rules and regulations
• •Experience with medical chart review
• •An understanding of billing issues and reimbursement
• •Extensive knowledge of ICD-10, and CPT coding
• •Ability to read, analyze, and interpret financial reports
• •Ability to define problems, collect data, establish facts, draw conclusions, and make sound recommendations
• •Capacity to analyze and think creatively and weigh alternatives
• •Perception of people and an awareness to deal with conflict successfully and attain resolution
• •Attention to detail
• •Excellent organizational skills
• •Skills in multitasking
• •Maintain strict adherence to the Beth Israel Lahey Health Confidentiality policy
• •Incorporate Beth Israel Lahey Health Standards of Behavior and Guiding Principles into daily activities
• •Comply with all Beth Israel Lahey Health Policies
• •Comply with the behavioral expectations of the department and Beth Israel Lahey Health
• •Maintain courteous and effective interactions with colleagues and patients
• •Demonstrate an understanding of the job description, performance expectations, and competency assessment
• •Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adhere to Customer Service standards
• •Participate in departmental and/or interdepartmental quality improvement activities
• •Participate in and successfully complete Mandatory Education
• •Beth Israel Lahey Health Standards of Behavior and Guiding Principles
• •Comprehensive fluency in English
• •Ability to read, analyze, and interpret financial reports
• •Ability to define problems, collect data, establish facts, draw conclusions, and make sound recommendations
• •Capacity to analyze and think creatively and weigh alternatives
• •Perception of people and an awareness to deal with conflict successfully and attain resolution
• •Demonstrates attention to detail
• •Demonstrates excellent organizational skills
• •Demonstrates skills in multitasking
• •Must be able to lift 50 lbs
• •Must be available for weekend shifts
• •Valid driver's license
• •Order to Cash
• •Procure to Pay
• •Supply Chain
• •Customers
• •Suppliers

Desired Qualifications

• •Applicable clinical or professional certifications/licenses such as RN, LPN, CPC, RT, MT, and RPH
• •Clinical education and/or utilization review experience
• •Epic Resolute HB
• •Master's degree preferred
• •Bachelor's degree, English major preferred
• •Excellent verbal and written communication skills
• •Demonstrated leadership in cross-functional teams
• •Must be able to effectively lead and coach others
• •Strong attention to detail
• •Helping customers gives you energy
• •Get charged up by interacting with others
• •You believe that food is central to our lives
• •Passionate about excellence
• •If you have a smile to share, we'd love to have you
• •We want amazing humans