Vendor Medical Coding Analyst

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $54.5k - $87.3k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

⚕️ Healthcare Insurance

Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Responsible for guiding the overall efficiency and accuracy of the vendor payment process • Audit and interpret medical procedures and terminology in medical documentation • Utilize critical thinking to determine best course of action for inquiries • Identify root cause of vendor payment issues • Conduct audits of vendor medical records • Collaborate with leadership to resolve issues • Track and oversee claims status as it moves through vendor and internal teams • Develop claims test case scenarios and ensure industry standard coding practices

🎯 Requirements

• Bachelor's degree required • Equivalent years of relevant work experience may be accepted in lieu of required education • Three (3) years Medical billing coding experience required • Three (3) years Managed Care experience preferred • Three (3) years of claims payment experience required • Knowledge of diagnosis codes, and CPT coding guidelines; medical terminology; anatomy and physiology; and Medicare/Medicaid/Commercial reimbursement guidelines • Intermediate level of Facets, Microsoft Word, Excel, PowerPoint and Access • Firm understanding of basic medical billing process • Reimbursement Methodology (APC, DRG, OPPS) preferred • Ability to generate reports & identify trends in coding

🏖️ Benefits

• Comprehensive total rewards package • Bonus tied to company and individual performance • Financial support for employee well-being