Medical Coding Analyst

We're Hiring: Medical Coding Analyst!

Location: Detroit, MI
Role: Medical Coding Analyst

We are seeking a detail-oriented and experienced Medical Coding Analyst to join our healthcare team. This role is for an Analyst with coding experience. The team takes new codes when released and researches and documents the reasons why a code will or will not be implemented into BCBSM policy and procedures. They review payability based on reviews within the team and information provided by providers in the network regarding the new codes.

We are looking for someone with analytical thinking/root-cause analysis experience who is also a team player. A diverse knowledge of the coding world and experience with AMA, CMS, HCPCS, CPT, and ICD-10 PCS codes is essential. Any type of certification for coding will be considered. (Candidates with a strong coding and analytical history but no certification may be considered on a case-by-case basis). Previous payor experience with systems, benefits, and provider networks is extremely helpful and will be prioritized in the interview process.

Engagement Description:

• Responsible for reviewing and researching new code changes released by Coding Authorities (AMA, CMS) for system implementation in PPO and HMO Commercial Business.

Top 3 Required Skills/Experience:

• Must be knowledgeable in the use of CPT, HCPCS, ICD-10-CM, and ICD-10-PCS code books
• RHIT or RHIA Certification Required
• Ability to analyze, investigate, and organize ideas in defining and formulating solutions

Education/Certifications:

• Bachelor's degree in a related field
• Certified Professional Coder

• Proficient in current industry standard PC applications and systems (e.g., Word, Excel, Microsoft Office)
• Ability to work independently and within a team environment while handling multiple priorities
• Strong oral and written communication skills
• Must be knowledgeable in the use of CPT, HCPCS, ICD-10-CM, and ICD-10-PCS code books
• RHIT or RHIA with specialty certification of CCS, CCS-P preferred
• Works collaboratively with physicians and other team members
• Knowledge of PPO and HMO claim systems and benefits is a plus
• Other related skills and/or abilities may be required to perform this job

Preferred Skills/Experience:

• Previous experience working with NASCO or MOS systems preferred

Ready to make an impact? 🚀 Apply now and let's grow together!