Coding Policy Analyst
Providence
full-time
Posted on:
Location Type: Remote
Location: Remote • California, Oregon, Washington • 🇺🇸 United States
Visit company websiteSalary
💰 $32 - $51 per hour
Job Level
Mid-LevelSenior
Tech Stack
PHP
About the role
- Responsible for updating and creating Coding Policies and associated edit configurations within the PHP claims editing system
- Reply to provider and member appeals providing appropriate CPT, CMS, specialty society, Coding Policy, and documentation rationale for Coding Policy edits
- Monitor changes to codes, coding guidelines and regulations, and coding edits from external agencies
- Assist with implementation of such changes to the claims adjudication and editing software
- Serve as a coding subject matter expert to other departments within PHP for questions about CPT, HCPCS, and ICD-10 codes
Requirements
- Coding certification through AAPC (CPC) or AHIMA (CCS) upon hire
- 5 years of experience directly related to CPT coding from chart extraction with a health care provider, a health insurance company, or a capitated managed care company
- 5 years of excellent writing and grammar skills required
- 5 years of demonstrated experience in detailed coding applications, as well as Microsoft Office capabilities, such as Excel, Word, and Access
- Bachelor's Degree or experience in a Healthcare or Health Plan setting coding and auditing will also be considered (preferred)
Benefits
- Comprehensive benefits package including health care benefits (medical, dental, vision)
- Retirement 401(k) Savings Plan with employer matching
- Paid time off including paid parental leave, vacations, holidays, and health issues
- Disability insurance
- Life insurance
- Wellness resources and much more
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
CPT codingHCPCS codingICD-10 codingcoding policiescoding guidelinesclaims adjudicationcoding applicationschart extractiondocumentation rationale
Soft skills
writing skillsgrammar skillscommunication skills
Certifications
CPCCCS