Top Talent Solutions is looking for Clinical Coders to work at a company located in Plymouth.
The Clinical Coders are expert resources for implementing and communicating HIPAA approved code sets and guidelines. The Clinical Coders interface with providers, as well as medical directors and other internal and external customers, being a key stakeholder in complex claims issue resolution. This position provides coding expertise and analysis to drive proper implementation of claim system edits to support policies as well as ensuring that service codes are appropriately aligned to drive member benefits. The Clinical Coders develop educational tools to meet the needs of key stakeholders including the network providers. The Clinical Coders represent the companies at various external State committee meetings such as Minnesota Administrative Uniformity Committee – Medical Code Tag (AUC) and the State Uniform Billing Committee (SUBC).
We are not looking for individuals to actually code claims, but rather to understand coding, how it relates to claim setup and policies.
Education Level: Bachelor's Degree
Years of experience required: 3 years
Specific types of experience required:
A minimum of 3 years of coding, billing and/or claims processing experience related to professional billing and diagnosis coding (CMS 1500, CPT, HCPCS, ICD 9 codes and ICD10) and hospital/facilities billing (UB04, Revenue Codes, DRGs, APCs and ICD 9 and 10 diagnosis and procedural codes)
REQUIRED CERTIFICATIONS/LICENSURE:
Coding certification (CCA, CPC-P, CPC, CPC-H, CCS, CCS-P, RHIT, RHIA) Needed to come in as a contractor!!
SKILLS/ABILITIES:
The desired candidate should have strong analytical, systems and coding skills related to the life cycle of healthcare claims. The candidate should have the ability to understand and empathize with the member and provider needs, while working to achieve the health plans business and financial goals as impacted by operational processes and procedures. The candidate should have the ability to relate to a wide variety of professionals, providing coding expertise for complex situations requiring in-depth problem solving skills and high level decisions. The desired candidate must have strong business acumen and analytical abilities to review claims data and trends, and to work with the necessary stakeholders to identify and implement effective solutions. Strong communication and presentation skills are required.
Excellent written and verbal communication skills
Possess excellent time management and prioritization skills in order to meet multiple deadlines; comfortable working in a high-paced environment
Self-driven, ability to work independently and facilitate change
Strong computer skills: Microsoft Office including Word, Access, Excel, PowerPoint and Visio
Ability to maintain understanding of numerous processes
Logical, detail-oriented thought process with the ability to breakdown complex problems and identify root causes
Ability to identify payment errors regardless of claim system by reviewing data and possessing claims coding experience
Medicare and Medicaid experience a plus.
Facility Coding experience a plus.
Excellent written and verbal communication skills.
Possess excellent time management and prioritization skills in order to meet multiple deadlines; comfortable working in a high-paced environment.
Self-driven, ability to work independently and facilitate change.
Strong computer skills: Microsoft Office including Word, Access, Excel, PowerPoint and Visio.
Ability to maintain understanding of numerous processes.
Logical, detail-oriented thought process with the ability to breakdown complex problems and identify root causes.
Ability to identify payment errors regardless of claim system by reviewing data and possessing claims coding experience.
Medicare and Medicaid experience a plus.
Facility Coding experience a plus.
Top Talent Solutions offers immediate placements for temporary, temp-to-hire and direct hire positions in all industries – from light industrial to administrative, and everything in between. But, we go a step further to offer you the personal touch that’s missing from so many other employment firms. Locally owned and operated, with multiple locations throughout Minneapolis and St. Paul, Top Talent Solutions works with nearly 1000 of the top companies in the region – from small businesses to national corporations. Our vast network allows us to build the strategic partnerships that, ultimately, you will benefit from.
Top Talent Solutions is in Equal Opportunity and Drug Free Employer
