Job details
Salary $18.49 - $24.34 an hour job type full-time
Full job description
* position is eligible for remote / work from home opportunity *
Department: smrc
Telecommuting: yes
Paygrade: n14
Job title
Certified coding analyst
Job summary
The certified coding analyst performs coding analysis to ensure all claims billed to medicare (part a, b, & dme) are appropriately coded per coding standards and adheres to all medicare rules and regulationsThis position educates internal staff on coding standards and assists in the claim review process.
Key performance indicators
Performs billing and coding analysis
Provides coding education, advice, and guidance to internal staff and external entities
Performs quality assurance reviews
Essential functions
Key duties/responsibilities/accountabilities
Reviews and analyzes professional complex claims and supporting documentation for cpt and healthcare common procedures coding systems (hcpcs) level ii code verification to include accuracy and completeness.
Reviews and analyzes complex facility/institutional claims and supporting documentation for common procedural terminology (cpt), hcpcs level ii, health insurance prospective payment systems (hipps), and international classification of diseases (icd) code verification to include accuracy and completeness.
Applies coding knowledge to assess and ensure services/items billed are reasonable and necessary, supported by national and local policies, are under accepted billing and coding practices, and meet standards of medical care.
Makes coding determinations based on coding standards of practice and all applicable medicare rules and regulations for facility/institutional claims.
Conducts quality reviews through coding analysis and provides feedback to internal staff.
Assists with annual coding updates.
Develops, updates, and implements new hire, ongoing, and refresher training for coding and clinical staff.
Stays up-to-date on all medicare rules and regulations.
Effectively communicates accurate and concise information with internal departments, providers/suppliers, and the centers for medicare & medicaid services (cms).
Non-essential duties and functions
Other duties as assigned
Minimum qualifications
Associate degree in healthcare-related field or equivalent work experience
3 years` experience in professional or healthcare billing
Cpc, coc, cic, or other aapc designated credential
Demonstrated knowledge of medicare (parts a, b, & dme) rules and regulations
Demonstrated knowledge of cpt, hcpcs, and icd-10 rules and regulations
Excellent written and verbal communication skills
Advanced computer skills
Demonstrated problem solving skills
Preferred qualifications
Above requirements and the following:
Bachelor`s degree in healthcare-related field or equivalent work experience
5 years` experience in a professional or institutional billing
Coding experience in multiple specialties
Multiple coding certifications (cpc, cic, coc, etc.)
Certification as a certified professional medical auditor (cpma) or certified documentation expert outpatient (cdeo) or willingness to obtain within one year of hire
Environment and cognitive/physical demands
Office environment
Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve
Requires prolonged sitting and telephone use
Requires the use of office equipment such as computer terminals, telephones, copiers and printers
Infrequent lifting to 15 pounds
Infrequent stooping
Segregation of duties
Every employee is responsible to perform their duties and responsibilities in accordance with noridian values, policies and procedures, including but not limited to: segregation of duties principles, hipaa, security and privacy, cms requirements, the noridian compliance program and any other applicable laws, rules and regulations.
Statement of other duties
This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functionsEmployees may be requested to perform job related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or management.
Total rewards package:
Health, dental and vision insurance, voluntary insurance plans, health savings and flexible spending accounts, 401k and company match, company-paid life insurance, education assistance program, paid sick leave, paid holidays, increasing pto accrual plan, medical/parental/disability leave, workers compensation, retiree benefits, severance package, employee assistance program, financial and health wellness benefits, casual dress, open office setting, and online learning system.
Cms access compliance and regulation contingency statement
Some positions require compliance with (i) federal and agency specific regulations and related clauses included in noridian`s prime contracts with the government, (ii) background checks, and (iii) eligibility for a government-issued identification card.
Equal employment opportunity
Equal opportunity employer of minorities, females, protected veterans, and individuals with disabilities as well as sexual orientation or gender identity.
Other information
Job posting policy 6.05: new employees with noridian healthcare solutions will be eligible to apply for positions within their assigned department after successfully completing a 90-day reviewFor positions outside their department, they must attain a minimum of six months of service before they can apply.
Notice to colorado applicants:
Per colorado’s equal pay transparency rules act, below is the salary range for potential new hires that will be
Working/residing in the state of colorado.
Colorado salary range: $18.49 - $24.34
Other compensation: incentive plan
This job will be closed 10/19/2021 at 8:00am cstNo further applications will be considered.
Licenses & certifications
Required
Cpc, coc, cic or aapc
Preferred
American acad prof coders
Cert inpatient coder
Cert outpatient coder
Cert professional coder
Equal opportunity employer/protected veterans/individuals with disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicantHowever, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information41 cfr 60-1.35(c)
