This position works with the medical policy team and the clinical team to help codify necessity guidelines. Stay current with coding changes to apply specified coding methodology for benefit configuration and adjudication.
- Accounts for coding and abstracting of clinical guidelines, including diagnostic and procedural information.
- Researches and analyzes data needs for reimbursement.
- Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes.
- Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines.
- Serve as a contact and resource to employees within other departments of the health plan for coding issues.
- Works closely with Business Owners and end users to develop detail requirements to meet business needs.
- Performs analysis on projects and provides a project plan that shows the tasks needing to be completed and a time estimate for each task.
- Provides status reports that give a detailed description of the current project’s progress and indicates time devoted to each task of the project.
- Responds to ad hoc requests for support and analysis.
- Helps design plans for implementation, produce user documentation and training materials. May conduct end user training.
Other Job Requirements
Responsibilities
- Strong knowledge of insurance billing with claims adjudication experience
General Job Information
Title Medical Coding Analyst (REMOTE)
Grade 20
Work Experience Claims
Education Associates
License and Certifications – Required CCS – Certified Coding Specialist – Enterprise, CPC – Certified Professional Coder – Enterprise
License and Certifications – Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their
position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Magellan Health
Similar Jobs
-
Work From Home – Outpatient Coding Specialist II
Mercy
-
Chesterfield, MO
We’re a Little Different Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that …
-
Sr Programmer Analyst – Java with REACT – REMOTE Eligible
Apex Systems
-
Saint Louis, MO
Job Description Job #: 1131058 Opportunity Overview: Duties include providing high-quality solutions by coding, testing, debugging, documenting and maintaining programs. Develo…
-
Medical Coding Reviewer II
Centene
-
Chesterfield, MO
Position Purpose: Analyze provider billing practices by utilizing code auditing software, provider documentation, administrative policies, regulatory codes, legislative directiv…
No comments:
Post a Comment