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Medical Coding & Reimbursement Analyst
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Job Description
- Req#: R6751
Employer Industry: Healthcare
Why consider this job opportunity:
- Highly competitive total rewards package, including comprehensive medical, dental, and vision benefits, as well as a 401(k) plan with contributions from both the employee and employer
- Annual incentive bonus plan based on company achievement of goals
- Generous paid time off, including holidays, vacation, and volunteer time off
- Opportunities for professional development, mentorship, and tuition reimbursement
- Paid parental leave and adoption leave with financial assistance for adoption
- Employee discount program available
What to Expect (Job Responsibilities):
- Analyze and provide recommendations related to coding, bundling, modifiers, clinical edits, benefits, and enforcements to various internal teams
- Participate in provider, client, and network meetings, including provider education through written communication
- Review complex operative reports and provider information to ensure appropriate reimbursement and billing practices
- Interpret state and federal mandates and develop coding recommendations and payment policies
- Educate and assist internal customers on correct procedural coding for benefit and claim inquiries
What is Required (Qualifications):
- Bachelor's degree in Healthcare Administration, Business, Information Systems, or a related field; or five (5) years of relevant experience
- Certified Coder with AHIMA or AAPC
- Minimum of 3 years of professional experience in operational and/or analytical processes within the healthcare industry or managed care payer
- Ability to work independently and meet designated deadlines
- Intermediate knowledge of medical claims processing and proficiency in Microsoft Office applications
How to Stand Out (Preferred Qualifications):
- 5 years of professional experience in operational and/or analytical processes within the healthcare industry or managed care payer
- Strong understanding of core systems relevant to the employer, including Facets, Claims Xten, and NetworX
- Familiarity with the employer's claims, reimbursement, and benefit structures
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