Payment Integrity Coding Coordinator-medical coding certificate required
Awarded the Best Place to Work 2021, Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the quality of life of Arizonans by delivering a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
This remote work opportunity requires residency, and work to be performed, within the State of Arizona.
The Coding Coordinator is responsible for performing audit activities in the areas of data mining, contract compliance, itemized bill reviews and provider outreach/education for all claim types to validate correct claims coding and billing practices. This role includes the identification and correction of abusive and wasteful billing and coding practices by conducting pre and post-payment coding compliance audits, communicating recommended solutions, and facilitating corrections, recovery of overpayments and provide education to promote correct, accurate and consistent coding and billing practices among providers. The Coding Coordinator will also have direct responsibility to work with vendors and internal business units coordinating refund recoveries, managing inventory and invoicing in the areas of Credit balance, DRG audits and Secondary claim code edits ensure any corrections, recommendations or issues are resolved to satisfaction.
Required Work Experience
- 2 years of experience of professional/physician diagnostic and procedural coding, claims administration, claims auditing or related experience required (All Levels)
*Knowledge of medical terminology, ICD-10 CM & PCS, CPT and DRG codes
- High-School Diploma or GED in general field of study (All Levels)
- Certified Coding Certificate (CIC, COC, CCS or CPC),
PREFERRED QUALIFICATIONSPreferred Work Experience
- 4 years of experience of medical coding, claims administration, claims auditing or related experience required (All Levels)
- 2 years of relevant hospital inpatient coding experience including DRG assignment
- Experience with coding of all claim types (All Levels)
- Associate’s or Bachelor’s Degree in any general field of study. (All Levels)
- Certified Coding Certificate (CCS or CPC) (All Levels)
ESSENTIAL job functions AND RESPONSIBILITIES
BCBSAZ does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.
Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.