UCare

Coding Analyst Senior

7 days left

Employer
UCare
Location
Minneapolis, Minnesota
Posted
Oct 02, 2021
Closes
Oct 27, 2021
Ref
2586
Category
Healthcare
Employment Status
Full Time
Health Care that Starts with You!

Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.

UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.

Rewards

Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.

At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

www.ucare.org/careers/

EOE/AA

ABOUT UCARE

UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.

WORKING AT UCARE

Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.

Our strong culture has established UCare as a Star Tribune Top 150 Workplace for 12 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.

CODING ANALYST SENIOR

Work Location: Work from home, in the office or hybrid (in the office 3 or more days per week)

The health and safety of our employees, members, providers, and our community is our highest priority. Therefore, all new employees are expected to be fully vaccinated against COVID-19 prior to starting at UCare, subject to limited exceptions such as for a sincerely held religious belief or for medical reasons.

Position Description

This position is responsible to identify and analyze changes (additions, deletions, modifications) to CPT, HCPCS, ICD-10-PCS, ICD-10-CM code and proprietary laboratory codes and to facilitate timely implementation across all appropriate departments and business systems. Identify and analyze coding related changes to vendor and UCare-supported applications. Serve as a subject matter expert and provide information and education on coding and coding related issues and/or changes. Facilitate the development of education materials for key areas and identify training opportunities for internal and external customers. Validate edit recommendations and review of impact analysis on regulatory updates from vendor.

• Serve as liaison between appropriate UCare departments and vendors by maintaining coding changes for implementation of system updates, modifications, and rule termination, where required.

• Identify and analyze coding changes as they relate to accurate claims processing. Perform deep dive analysis of CES edit configuration and regulatory guidelines. Minimize rework by ensuring stakeholders are aware of and understand changes and impact on all lines of business.

• Subject Matter Expert for DHS Medical Supply Guide analysis for monthly changes/updates impacting CES editing. Provide approvals and sign off for changes/updates.

• Identify and analyze coding changes and provide direction to configuration team as they perform system updates or document configuration. Assist with the creation of test scenarios for system updates and review actual results received and provide approvals to move changes to production.

• Identify, research, and resolve inaccuracies and inconsistencies in the system as they impact claims payment and adjudication and other upstream and downstream transactions and processes.

• Create and maintain coding training manual to include coding policies and procedures (P&Ps)

• Develop and manage coding analyst audit process, including evaluation tool, measurement, and feedback and monitoring capabilities.

• Participate on internal and external committees and work groups as Coding subject matter expert.

• Support day-to-day operations and initiatives to assure the business operations are aligned with coding standards and guidelines. Make recommendations for improvements.

• Collaborate with Claims Training resources to ensure work instruction impacted by coding changes are identified and updates in a timely manner.

• Collaborate with Configuration staff to identify opportunities to maximize operational effectiveness and efficiency by reducing unnecessary rework, increasing automation, and improving auto-adjudication rates.

• Other projects and duties as assigned.

Education

High school diploma or equivalent. Current and valid certification as a professional coder from an accredited institution.

Required Experience

Five years of experience as a certified coder in a healthcare delivery setting, health insurance (payer) setting or Medicare and/or Medicaid setting. Experience with DME (Durable Medical Equipment) and Commercial business. Experience in a Managed Health Care organization. Experience with configuration of business rules in a healthcare claims processing application.

Preferred Experience

Amisys, HealthRules, Optum Claims Editing System (CES), Microsoft Word, Excel and PowerPoint skills.

THE UCARE DIFFERENCE

The UCare difference is our people power - employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.

As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

JOB POST DATE: 10/01/2021

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