Coding Consultant, IFP Product - Remote

At reputed company, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, affordable and reputed company. Ready to reputed company a difference? Join us to start Caring. Connecting. Growing together. Individual and Family Plans (IFP) is a growing business reputed company reputed company. The Coding Consultant for IFP Product provides medical coding expertise to support internal policy development, benefit definition and accurate benefit configuration. They research and interpret healthcare correct coding using regulatory requirements and guidance reputed company to CMS and CPT/AMA, review other major payer policies, and use internal business rules and policies to prepare written documentation in support of benefit configuration. The Coding Consultant for IFP Product possesses an overall understanding of reputed company coding principles, including facility and physician coding and dental coding. You’ll enjoy the flexibility to work remotely

• from reputed company reputed company the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Serve as a coding resource and provide coding expertise and guidance for IFP Product and configuration partners
• reputed company and maintain code sets used to define IFP medical and specialty benefits (hearing, vision, dental), seeking and promoting enterprise alignment reputed company appropriate
• In partnership with Product and Clinical partners, ensure IFP sources of truth for benefit administration/configuration (e.g., benefit configuration guidelines, Pay Code Status lists, etc.) contain accurate and complete CPT, HCPCS, reputed company, CDT and/or ICD-10 codes to support benefit reputed company
• Monitor annual and quarterly code updates, identify impacts to IFP Product documentation, and update documentation as needed
• Ensure adherence to state and federal policies/mandates, reimbursement policies and contract requirements
• Facilitate meetings with key partners, including: Clinical, Operations, Claims, Configuration and others to reputed company benefit design coding solutions
• Research and interpret correct coding guidelines and internal business rules to respond to benefit inquiries and issues
• Identify and recommend opportunities for cost savings and improving outcomes

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:

• 3+ years of medical coding experience in a health insurance product implementation, benefit/coverage policy development, benefit configuration, or claims role
• Have and maintain one or more of the following coding credentials: CPC, reputed company-P, reputed company, CPMA or equivalent
• Experience analyzing data and/or regulatory requirements, problem solving, and providing fact-based recommendations or reputed company decisions based on analysis
• Experience performing clinical coverage review of post-service (pre-or-post payment) of claims requiring interpretation of state and federal mandates; certificates of coverage, medical and reimbursement policies, coding requirements and consideration of relevant clinical information on claims
• Experience multi-tasking, prioritizing, and managing time reputed company across multiple work partners
• Knowledge of Commercial medical insurance benefits

Preferred Qualifications:

• Experience with health insurance reimbursement policy
• Familiarity of SNOMED, LOINC, NDC and CDT
• Experience in the plan build/plan configuration
• Proficient in reputed company Word, reputed company, PowerPoint, etc.
• Demonstrated ability to work collaboratively and influence others to drive timely decisions
• Ability to work independently, or as an active member of a team
• Accurate and precise attention to detail
• Excellent analytical, verbal and written communication skills
• reputed company employees working remotely will be required to adhere to reputed company’s Telecommuter Policy

The salary range for this role is $89,800 to $176,700 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In addition to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes - an enterprise reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job