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), Childrens 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 appeals and tracks provider appeals including sending correspondence to providers.

This position is responsible for the following:

Reviewing claims 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.

Tracking provider appeals and sends correspondence to providers on submitted appeals.

Serving as a consultant to various other departments within SelectHealth 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.

Supporting all internal departmental functions and processes.

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. Coding rules also vary by state and by line of business which adds complexity for each of these factors. (Select Health is currently in 3 main states but have a national network which impacts all 50 states.)

Responsible for compliance with all regulations: State and federal regulations vary by state and line of business. In addition to the state regulations, Select Health also manages multiple lines of business in several states. In general, Select Health manages Medicaid, Medicare, CHIP, FEHB, Self-funded, Fully insured large, small and individual plans (ACA and non-ACA), Rules are different for each of these groups and can also vary within a line of business for different geographies, which adds both scope and complexity to this role.

This role is Remote, though need to be in the Murray, Utah area. Flexible schedule Monday – Friday during business hours.

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Minimum Qualifications

Associate degree from an accredited institution. Education will be verified

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Two years of work experience in coding, healthcare, or in a health plan environment.

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Demonstrated Intermediate level experience with Microsoft Office applications.

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Demonstrated excellent written and verbal communication and presentation skills.

Preferred Qualifications

Bachelors Degree from an accredited institution. Education will be verified.

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National professional coding certification (e.g., Certified Professional Coder (CPC), Certified Coding Specialist (CCS)). Must be obtained within one year of hire. If not obtained within this time period, the caregiver is removed from the position.

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Two years of coding or auditing experience in a professional, facility, or health plan environment.

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Excellent organizational, analytical, and communication skills.

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Demonstrated ability to establish and maintain rapport with co-workers, physicians, and other health care providers.

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Demonstrated ability to perform tasks independently and with minimal supervision.

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Demonstrated sound judgment and decision-making skills.

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Experience with Government programs (Medicare, Medicaid, or ACA)

Physical Requirements:

SH only

Interact with others requiring the employee to communicate information.

– and –

Operate computers and other equipment requiring the ability to move fingers and hands.

– and –

See and read computer monitors and documents.

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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 packages for our Idaho, Nevada, and Utah based caregivers (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/) , and for our Colorado, Montana, and Kansas based caregivers (http://www.sclhealthbenefits.org) ; and our commitment to diversity, equity, and inclusion (https://intermountainhealthcare.org/careers/working-for-intermountain/diversity/) .

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.