Manages claims coding rule process. Evaluates claims coding rule change request from clinical, financial, and claims operations perspectives and make recommendations. Maintains and configures claims coding rule software. Oversees and trains coding staff.
Education: Associate's degree or relevant industry experience.
Experience: 3-5 year's medical coding experience with a hospital or payer organization. Experience working with health insurance claims payment system.
Advance user of IntelliClaim
Experience with Fair Isaac Payment Optimizer preferred
Licenses/Certifications: CCS, RHIA, or RHIT
Technical Skills/Requirements: Billing expertise in UB92, 1500 and other healthcare services
Strong knowledge of electronic medical records/billing systems and medical terminology and abbreviations
Knowledge of 3M Encoder a plus