Coding Systems Analyst
$72,500–$90,600 year
RemoteUnited States
EXPIREDUnited StatesRemoteFull Time$72,500–$90,600 yearBachelors DegreeMedium
Full TimeBachelors DegreeMedium
Job Summary
Research official coding guidelines, industry sources, and Quartz contracts to evaluate and test system edits supporting compliance and payment integrity. Present recommendations regarding financial savings and regulatory alignment to multi-disciplinary teams and leadership using analytics. Collaborate with business analysts to provide input on quarterly system updates, routine maintenance, and enhancements across two separate claim edit systems. Prepare educational materials for providers on new edits and financial impacts while monitoring daily system performance trends.
Required Qualifications
- Bachelor's degree with 2+ years of relevant coding experience
- OR associate degree with 5+ years of relevant coding experience
- OR high school equivalency with 8+ years of relevant coding experience
- Completion of medical coding program (obtained certification in CPC, COC, RHIT, RHIA, CCA, and/or CCS)
- Epic healthcare software and/or system knowledge of Optum CES or Claritev ACE claim editing systems
- Intermediate level of proficiency with MS Office (Word, Excel, PowerPoint, and Outlook)
- Ability to decipher complex CMS coding and billing regulations for all types of coding
- Strong working knowledge of medical coding, fee, and reimbursement mechanisms
- Strong understanding of medical coding and regulatory guidelines, which may include - CPT, HCPCS, ICD10, OPPS, IPPS, DRGs
- Strong knowledge of governmental medical payment policies/regulations and their update process (Medicare, Medicaid, DSNP, SSI, etc.)
- Knowledge of HIPAA regulations
- Ability to understand and discuss technical software issues with others
- Strong analytical and problem-solving skills using critical thinking skills
- Strong verbal and written communication skills
- Self-motivated, organized, with the ability to work independently to successfully investigate complex issues, and manage multiple tasks simultaneously and complete timely
- Ability to engage and work in a collaborative team environment
- Access to high-speed, non-satellite Internet
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