Coding Review Analyst

Retrieved 8 days ago from Remote

Coding Review Analyst

  • Remote - Minnesota
  • Remote - Alabama
  • Remote - Maryland
  • Remote - Maine
  • Remote - Louisiana
  • Remote - Kentucky
  • Remote - Kansas
  • Remote - Iowa
  • Remote - Indiana
  • Remote - Wyoming
  • Remote - Oregon
  • Remote - Wisconsin
  • Remote - New Hampshire
  • Remote - Nevada
  • Remote - West Virginia
  • Remote - Nebraska
  • Remote - Washington
  • Remote - Montana
  • Remote - Virginia
  • Remote - Missouri
  • Remote - Vermont
  • Remote - Mississippi
  • Remote - Utah
  • Remote - Texas
  • Remote - Tennessee
  • Remote - Michigan
  • Remote - Ohio
  • Remote - Massachusetts
  • Remote - South Dakota
  • Remote - South Carolina
  • Remote - North Dakota
  • Remote - Rhode Island
  • Remote - North Carolina
  • Remote - Pennsylvania
  • Remote - New York
  • Remote - New Mexico
  • Remote - New Jersey
  • Remote - Illinois
  • Remote - Idaho
  • Remote - Georgia
  • Remote - Florida
  • Remote - Delaware
  • Remote - DC
  • Remote - Connecticut
  • Remote - Colorado
  • Remote - Oklahoma
  • Remote - California
  • Remote - Arkansas
  • Remote - Arizona
  • Full time
  • R4422

Transforming the future of healthcare isn’t something we take lightly. It takes teams of the best and the brightest, working together to make an impact.

As one of the largest healthcare technology companies in the U.S., we are a catalyst to accelerate the journey toward improved lives and healthier communities.

Here at Change Healthcare, we’re using our influence to drive positive changes across the industry, and we want motivated and passionate people like you to help us continue to bring new and innovative ideas to life.

If you’re ready to embrace your passion and do what you love with a company that’s committed to supporting your future, then you belong at Change Healthcare.

Pursue purpose. Champion innovation. Earn trust. Be agile. Include all.

Empower Your Future. Make a Difference.

Current Need-Coding Analyst

Position Description

The Payment Integrity Coding Analyst researches and interprets healthcare correct coding using regulatory requirements and guidance related to CMS, CPT/AMA and other major payer policies. They also use internal business rules to prepare written documentation of findings through medical record review. The Coding Analyst possesses an overall understanding of all coding principles, including facility, provider and DME type coding and provide health care payers with a total claims management solution. Typically, 90% of a Coding Analyst’s time is spent performing coding and documentation review and 10% spent performing other tasks as assigned. This position is remote.

If you have a solid understanding of CPT Coding and CMS rules and regulations, and possess excellent writing and computer skills, take the next step towards a rewarding coding career at Change Healthcare!

Responsibilities:

  • Conducts coding reviews of medical records and supporting documentation against submitted claims, for individual provider and facility claims, to determine coding and billing accurate for all products.
  • Process and/or review claims in a timely manner utilizing client specific coding and billing requirements that meet or exceed production and quality goals.
  • Documents coding review findings within investigative case tracking system and maintains thorough and objective documentation of findings.
  • Serves as a coding resource and provides coding expertise and guidance to entire investigation and/or clinical team.
  • Monitors, tracks and reports on all case work.
  • Communicates determinations verbally and/or in writing to appropriate business department as required by department internal workflow policies.
  • Participates in process improvement activities and encourages ownership of and group participation in improvement initiatives.
  • Identifies and recommends opportunities for cost savings and improving outcomes.
  • Analyze medical documents to evaluate potential issues of fraud and abuse.
  • Coordinate activities with varying levels of leadership, investigative team, legal counsel, internal and external customers, law enforcement and regulatory agencies, and medical professionals through effective verbal and written communications.
  • Monitor CMS and major payer coding and reimbursement policies.
  • Researches and interpret correct coding guidelines and internal business rules to respond to customer inquiries.

Minimum Requirements:

  • 3+ years’ experience in coding with primary focus in facility and pro fee coding
  • Nationally recognized coding credential required: RHIA, RHIT, CCS-P, or CPC

Critical Skills (Required)

  • Excellent communication skills both verbal and written
  • Proficiency in navigating various computer applications with the ability to ramp up quickly
  • Understanding of Microsoft products including Outlook, Excel and Word.
  • Proven ability to review, analyze, and research coding issues
  • 4+ years of hospital and physician medical claims experience
  • Reimbursement policy and/or claims software analyst experience (Desired)
  • Knowledge of claims editing software and rules development (Desired)
  • Must be available to work full-time, Monday-Friday (time to be determined)
  • Ability to establish good customer relationships with trust and respect
  • Good interpersonal skills
  • Self-starting and independent, able to stay focused while working remotely
  • Attention to detail

Education

  • AS degree or Equivalent in Health Information Management required

Physical Requirements

  • Ability to work in front of a computer nearly 100% of each day.
  • Ability to work independently and communicate primarily through instant messaging (Skype, Jabber), email (Outlook) or the telephone.

Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!

Equal Opportunity/Affirmative Action Commitment

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

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