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Portland, ME 04103
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.
Title: Coding Analyst
Overview of Position:
The Payment Integrity Coding Analyst possesses a solid understanding of CPT Coding and CMS rules and regulations along with excellent writing and computer skills. This position frequently 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.
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!
What will be my duties and responsibilities in this job?
- 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, and participates in process improvement activities and encourages ownership of and group participation in improvement initiatives, and analyzes medical documents to evaluate potential issues of fraud and abuse.
- 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 and 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 and Identifies and recommends opportunities for cost savings and improving outcomes.
- 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.
- Researches and interpret correct coding guidelines and internal business rules to respond to customer inquiries, and monitors CMS and major payer coding and reimbursement policies.
What are the requirements needed for this position?
- 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
- 4+ years of hospital and physician medical claims experience.
- Understanding of Microsoft products including Outlook, Excel and Word.
- Proven ability to review, analyze, and research coding issues.
- Reimbursement policy and/or claims software analyst experience
Knowledge of claims editing software and rules development
- AS degree or Equivalent in Health Information Management required
What other skills/experience would be helpful to have?
- Excellent communication skills both verbal and written with a high attention to detail.
- Proficiency in navigating various computer applications with the ability to ramp up quickly.
- Ability to learn and navigate multiple computer programs quickly and effectively.
- 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 is critical.
What are the working conditions and physical requirements of this job?
- Must be available to work full-time, Monday-Friday (time to be determined).
- 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.
How much should I expect to travel?
No travel is required for this position.
Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!
Equal Opportunity/Affirmative Action Statement
Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf.
If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to firstname.lastname@example.org “Applicant requesting reasonable accommodation” as the subject. Resumes or CVs submitted to this email box will not be accepted.
Click here https://www.dol.gov/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdfto view our pay transparency nondiscrimination policy.
Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.
Change Healthcare is an Equal Opportunity Employer. Employment at Change Healthcare is based upon your individual merit and qualifications. We don’t discriminate on the basis of race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, physical or mental disability, marital status, protected veteran status or disability, genetic characteristic, or any other characteristic protected by applicable federal, state or local law. We will also make all reasonable accommodations to meet our obligations under the Americans with Disabilities Act (ADA) and state disability laws. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability.