Coding Analyst I

SelectHealth · Murray · $31.01 - $48.84 The Coding Analyst I for SelectHealth provides general expertise in the areas of all areas of coding (professional, facility (inpatient and outpatient), drug, Durable Medical Equipment (DME), and lab code sets) for highly-regulated, government insurance programs such as Medicare, Medicaid, Affordable Care Act (ACA), Children's Health Insurance Program (CHIP), Federal Employees Health Benefit (FEHB) program, and self-funded plans with unique plan designs, reimbursement, compliance initiatives, regulatory legislation, and billing practices. This analyst reviews claims and monitors provider appeals including sending correspondence to providers. Essential Functions Reviewing claims (pre-payment) to monitor billing practices and ensure accurate coding and reimbursement based on specific contracts, payment methodologies and state and federal regulations that vary by geography and lines of business Ensures review decisions are in line with Employee Retirement Income Security Act (ERISA) standards. Logging provider appeals and sends correspondence to providers on submitted appeals. Serving as a consultant to various other departments within Select Health and departments within Intermountain Healthcare including physicians and facilities. Supporting higher level analysts in their responsibilities and research. Maintaining subject-matter expertise and educates providers and staff accordingly. Responsible for compliance with all coding regulations for all provider specialties (surgical and non-surgical) and coding methodologies. Responsible for compliance with all regulations: State and federal regulations vary by state and line of business. Physical Requirements Ongoing need for employee to see and read information, documents, monitors, identify equipment and supplies, and be able to assess customer needs. Frequent interactions with providers, colleagues, customers, and members that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately. Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment. Benefits We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.