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Surgical Procedure Coding Analyst
Job ID R29977
Date posted 11/02/2022
Change Healthcare is a leading healthcare technology company with a mission to inspire a better healthcare system. We deliver innovative solutions to patients, hospitals, and insurance companies to improve clinical decision making, simplify financial processes, and enable better patient experiences to improve lives and support healthier communities.
- Fully Remote - U.S.
The Surgical Procedure 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 claim 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.
- Conduct 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.
- Participate in process improvement activities and encourage ownership of and group participation in improvement initiatives
- Analyze medical documents to evaluate potential issues of fraud and abuse.
- Document coding review findings within investigative case tracking system and maintains thorough and objective documentation of findings.
- Serve as a coding resource and provide coding expertise and guidance to entire investigation and/or clinical team
- Monitor, track, and report on all case work.
- Communicate determinations verbally and/or in writing to appropriate business department as required by department internal workflow policies
- Identify and recommend opportunities for cost savings and improving outcomes.
- Coordinate activities with varying levels of leadership including the investigative team, legal counsel, internal and external customers, law enforcement and regulatory agencies, and medical professionals through effective verbal and written communications.
- Research and interpret correct coding guidelines and internal business rules to respond to customer inquiries, and monitors CMS and major payer coding and reimbursement policies.
- Must be able to take and pass Coding Assessme
- High School Diploma AND 4 years of professional work experience
- 3+ years’ experience of advanced medical coding (hospital outpatient surgery procedures).
- Coding credentials: RHIA, RHIT, CCS-P, CCS or CPC
- Experience in reviewing, analyzing, and researching coding issues
- Advance proficiency in Microsoft Office skills including Outlook, Excel, and Word
- Associate Degree or equivalent in Health Information Management
- Experience with reimbursement policy and/or claims
- 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 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
Working Conditions/Physical Requirements:
- General office demands
- Flexible work environments
- Ready, Set, Grow Career Development Center & access to Change Healthcare University for continuous professional learning & development with more than 5,000 training assets
- Volunteer days, employee giving and matching gifts programs, community awards and dollars for doers, community partnerships
- Employee wellbeing programs and generous health plans
- Educational assistance programs
- US 401(k) or Group RRSP (Canada) savings plans with matching employer contributions
- Be sure to ask our Talent Advisors for more information on location specific benefits and paid time off policies
- Learn more at https://careers.changehealthcare.com
- *Eligibility for some benefits may be limited or not available for part-time employees, be sure to speak with your Talent Advisor.
Diversity and Inclusion:
- At Change Healthcare, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.
- Business Resource Groups (BRGs) play a central role in advancing diversity and inclusion at Change Healthcare. They deepen our understanding of different cultures, people, and experiences, and help foster an inclusive workplace. Change offers eight (8) BRGs. Learn more at https://careers.changehealthcare.com/diversity
Feeling Inspired? Ready to #MakeAChange? Apply today!
Diversity, Equity & Inclusion:
•At Change Healthcare, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.
•Business Resource Groups (BRGs) play a central role in advancing diversity and inclusion at Change Healthcare. They deepen our understanding of different cultures, people, and experiences, and help foster an inclusive workplace. Change offers eight (8) BRGs. Learn more at https://careers.changehealthcare.com/diversity
Feeling Inspired? Ready to #MakeAChange? Apply today!
COVID Vaccination Requirements
We remain committed to doing our part to ensure the health, safety and well-being of our team members and our communities. As such, some individuals may be required to disclose COVID-19 vaccination status prior to or during employment. Certain roles may require COVID-19 vaccination and/or testing as a condition of employment. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.
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 email@example.com with "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.pdf to view our pay transparency nondiscrimination policy.
California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcare’s Privacy Notice to California Job Applicants Regarding the Collection of Personal Information.
Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.
Talent Acquisition Process
Once you apply for a job opening, the Sourcing Specialist or Talent Advisor will review your resume ensuring your background matches the minimum job requirements. Selected candidates will be invited for a phone screen.
Steps will vary by team, but typically include: Talent Advisor phone screen, hiring manager interview, and a combination of technical screens and panel interviews.
If you're selected, you can expect the Talent Advisor to reach out with specific offer details. During this stage you will be provided with an electronic offer letter and other new hire documents.
Once you've electronically signed your offer, our onboarding team will get you ready for Week 1 and set you up for success! Onboarding tasks may include a background check, drug screening, and other job specific requirements.
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