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Health Services Coding Analyst, CPC Required
Location
Iowa
Posted
68 days ago
Salary
0
Seniority
Lead
Job Description
Health Services Coding Analyst, CPC Required
Wellmark Blue Cross and Blue Shield
• Provide clinical leadership and subject-matter expertise to support the analysis, configuration, and administration of complex medical policy content within claims processing systems, including Plan General Exclusion (PGE) rules and FACETS table maintenance. • Ensure the accurate implementation of medical policies, review criteria, and authorization requirements, while maintaining the integrity of system infrastructure. • Serve as a key liaison between business and technical teams. • Research and analyze system and business issues, develop high-level requirements, test and implement solutions, and audit and document outcomes. • Serve as an expert resource for medical policy configuration and PGE coding, mentoring and training Coding Specialists, and providing policy-related training and support to operational partners such as customer and provider services. • Must be willing to work core business hours of 8 AM - 5 PM Central Time.
Job Requirements
- Associate degree or direct and applicable work experience preferred.
- Certified Professional Coder (CPC) required.
- Clinical background which may include either formal education or training in a clinical or health-related discipline (such as nursing, medical assisting, surgical technology, health information management, or a related field) and/or direct work experience in a clinical or healthcare setting.
- 7+ years’ or related health care experience in provider payment, claims, medical coding, or similar.
- Demonstrated expertise and knowledge of medical coding and terminology.
- Demonstrated strong attention to detail with the ability to multitask.
- Strong interpersonal skills including clear and concise written and verbal communication.
- Inquisitive nature, enthusiastic about developing and enacting new processes.
- Strong workflow management skills with sense of ownership, drive and initiative to continuously improve outcomes.
- Ability to communicate concepts clearly and concisely to individuals and groups and motivate others to achieve success with an eye toward promoting a culture of collegiality and excellence.
- Demonstrated ability to obtain relevant information by relating and comparing data from different sources.
- Proficiency in Microsoft Office applications including experience with spreadsheets, process mapping, presentation and word processing.
- Ability to adhere to quality and production metrics.
- Some experience with and continued interest in coaching and mentoring others.
- Demonstrated ability to consistently meet department work schedule.
Benefits
- Health Services Coding Analyst (CPC Required)
- Remote Eligible
- Great to have: Prior health plan experience.
- Must provide high-speed internet.
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State of ColoradoThe State of Colorado is located in the Rocky Mountain region of the western United States. It entered the 100-year-old Union in 1876, earning the nickname "Centennial State." The
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About this Unit: The Food and Energy Assistance Division is responsible for the administration of several major Federal programs such as the Supplemental Nutrition Assistance Program (SNAP), Electronic Benefit Transfer (EBT) program, Food Distribution Programs (FDP), the Summer Electronic Benefit Transfer (S-EBT) program and the Low Income Energy Assistance Program (LEAP) and associated support systems and subprograms that address food and energy needs for Coloradans. In a state-run, county-administered system, this unit is responsible for the oversight of county operations. Specifically, the Performance Team unit creates, implements, and monitors the application of policy, procedures, and rules for SNAP. The unit is also responsible for performing comprehensive management evaluations of localoperations, SNAP issuance accountability and monitoring, performance evaluation through data analysis, and monitoring participation, performance improvement planning and implementation. 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