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Claims Coding Analyst

  • Location: Minnetonka, MN
  • Job Type: Right to Hire
  • Ref No: 20-02528
  • Date: May 28, 2020
  • Job title:

Ashley Gowen

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Job Description - Claims Coding Analyst

Healthcare Claims Coding Analyst

Minneapolis – St Paul, MN

6-month contract-to-hire


 

Our direct and long-term client in the Twin Cities is currently seeking an experienced Claims Coding Analyst to join their Claims Operations team! This is a well-respected organization with professional growth opportunities!

 

Required Qualifications

  • Professional claims processing experience
  • Professional medical coding experience
  • Accredited Certifications from AAPC, AHIMA or comprable:  CCS, RHIT, CPC,  
  • Deep understanding of medical claim data (terminology, claim structure and data elements)
  • Deep understanding of medical claim adjudication process (claim life cycle from intake to adjudication)
  • Strong Reporting Skills
  • Ability to research and analyze data, draw conclusions, and resolve issues
  • Must have solid Microsoft Office Skills ( MS Excel, Word, etc. )
  • Bachelor's degree in Business Administration, Healthcare Administration, Healthcare Management, Healthcare Informatics or related degree program; or equivalent combination of education and related work experience

 

Primary Responsibilities

  • Demonstrate knowledge and utilize knowledge of contracts and performance requirements, claims and processing workflow, and payment process
  • Research and resolution of coding projects as assigned
  • Adherence to coding guidelines, applications, and practices
  • Apply policies and procedures to confirm that claims meet the criteria for payment as indicated in contractual guidelines
  • Conducts analysis around various claims payment processes to ensure accuracy of system configuration and provider payments.
  • Investigates problem claims to determine root cause of problem and/or error to address both individual claim resolution and improvement to process to avoid issues from occurring in the future.
  • Perform and execute various claims process testing requests to ensure desired results are met to support accurate claims payments

 




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