Medical Coding Analyst, Senior

7 days ago

Kansas City, United States Blue Cross and Blue Shield of Kansas City Full time
Guided by our core values and commitment to your success, we provide health, financial and lifestyle benefits to ensure a best-in-class employee experience. Some of our offerings include:
  • Highly competitive total rewards package, including comprehensive medical, dental and vision benefits as well as a 401(k) plan that both the employee and employer contribute
  • Annual incentive bonus plan based on company achievement of goals
  • Time away from work including paid holidays, paid time off and volunteer time off
  • Professional development courses, mentorship opportunities, and tuition reimbursement program
  • Paid parental leave and adoption leave with adoption financial assistance
  • Employee discount program
Job Description Summary: Researches, coordinates, analyzes, and resolves complex claim inquiries to align with coding requirements for established medical/payment policy. Follows company guidelines and refers issues as appropriate to medical policy and payment policy for additional review. Acts as a medical review subject matter expert on issues relating to system edit impacts on medical reviews, as well as reimbursement. Must possess an in-depth understanding of medical coding, provider reimbursement, and medical policy. Job Description
  • Researches and reviews written claim inquiries submitted to the company for determination regarding claims bundling and coding issues. This includes reviewing complex operative reports and provider information regarding procedures and requesting provider documentation as needed to complete reviews.
  • Reviews appropriate use of modifiers and codes being submitted by providers. Provides coding perspective and refers for additional review as appropriate per Medical Policy.
  • Identifies incorrect or inconsistent computer programming edit information within FACETS and ClaimsXten, and coordinates resolution with appropriate staff members.
  • Collaborates with Provider Solutions and Provider Operations and Services Support regarding system edits that impact claim inquiry reviews sent to Medical Management. This includes assisting to identify root causes,and recommends efficiencies to improve provider and member experience.
  • Collects relevant data to aid reporting, project tracking and staff performance management.
  • Provide system update support regarding Medical Management prior authorization tables.
  • Acts as medical coding subject matter expert and will organize coding related training for nurses on the medical review and prior authorization team.
  • Prepares outcome reports that show findings from project/contract activities. Effectively communicates project finding to internal and external clients
  • Provides analysis and recommendations to Provider Payment, Provider Solutions, and Medical Policy team as it relates to coding, bundling, modifiers, clinical edits, and enforcements
  • Builds relationships with other departments within Blue KC to successfully drive accurate and timely initiatives related to medical codes and reimbursement.

Minimum Qualifications

  • Associate's degree in applied sciences, and 2-3 years of experience in a medical insurance or healthcare environment; or any combination of education and experience providing the types and levels of knowledge, skills, and abilities required by the job.
  • Must have at least 3 years medical coding experience
  • Coding certification
  • Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures, operative reports or governmental regulations.
  • Ability to write reports, business correspondence and business manuals.
  • Ability to effectively present information in one-on-one and small group situations to customers, clients and other employees of the organization.
  • Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, and percentages.
  • Ability to apply basic concepts of algebra.
  • Ability to define problems, collect data, establish facts and draw valid conclusions.
  • Ability to interpret an extensive variety of technical instructions and deal with several abstract and concrete variables.
  • Intermediate level keyboard skills.
  • Intermediate knowledge of and skill using Microsoft Windows.
  • Intermediate level knowledge of Microsoft Office Word, Excel, and Access, or similar PC-based programs.
  • Intermediate knowledge of medical terminology and medical claims diagnosis and procedure coding.

Preferred Qualifications

  • 10 years of experience with procedural coding, payer preferred.
  • Intermediate knowledge of and skill using automatic electronic claims processing software (FACETS) and e-mail systems.

Blue Cross and Blue Shield of Kansas City is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to, among other things, race, color, religion, sex, sexual orientation, gender identity, national origin, age, status as a protected veteran, or disability.

  • Medical Coding Instructor

    3 weeks ago

    Kansas City, United States KC MEDICAL CODING TRAINING LLC Full time

    Job DescriptionJob DescriptionConduct classes in online environment. Develop detailed lesson plans and course materials via the AAPC Blackboard. Evaluate student academic performance. Implement instructional plans with efficacy. Maintain the security and privacy of assessment tools and records. Oversee and operate learning management systems...

  • Senior Financial Analyst

    8 hours ago

    Kansas City, Kansas, United States The University of Kansas Health System Full time

    Senior Financial AnalystJoin The University of Kansas Health System as a Senior Financial Analyst and contribute to the success of our organization. As a key member of our finance team, you will be responsible for maintaining and enhancing the hospital's cost accounting system, developing and analyzing financial reporting tools, and preparing special reports...

  • Senior Medical Coding Reviewer

    16 hours ago

    Jefferson City, Missouri, United States Centene Corporation Full time

    Job Title: Senior Medical Coding ReviewerJoin Centene Corporation, a leading healthcare company, as a Senior Medical Coding Reviewer. In this role, you will play a critical part in ensuring the accuracy and compliance of medical coding practices across our organization.Key Responsibilities:Perform medical claim reviews to ensure compliance with coding...

  • Medical Coding Specialist

    3 weeks ago

    Kansas City, Missouri, United States NSN Revenue Resources Full time

    Job Title: Medical Coding SpecialistNSN Revenue Resources is seeking a skilled Medical Coding Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for assigning accurate medical codes to facility charges, ensuring compliance with coding guidelines and regulations.Responsibilities:Review and analyze medical records...

  • Medical Coding Specialist

    4 weeks ago

    Kansas City, Missouri, United States NSN Revenue Resources Full time

    Job Title: Medical Coding SpecialistNSN Revenue Resources is seeking a skilled Medical Coding Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for assigning accurate medical codes to facility charges, ensuring compliance with coding guidelines and regulations.Responsibilities:Review and analyze medical records...

  • Senior Analyst

    3 weeks ago

    Kansas City, Kansas, United States Walker & Dunlop Full time

    Job SummaryWe are seeking a highly skilled Senior Analyst to join our team at Walker & Dunlop, a leading provider of capital to the commercial real estate industry. As a Senior Analyst, you will play a critical role in assisting in the creation and dissemination of marketing materials for investment-grade multifamily properties throughout your Region. You...

  • Medical Coding Specialist

    2 weeks ago

    Kansas City, United States NSN Revenue Resources Full time

    Job Type Full-time Description Position Overview: Reporting to the Coding Manager, the Coding Specialist is responsible for assigning medical codes to facility charges for multispecialty outpatient surgical facilities resulting in claims reimbursement. Responsibilities: Review and analyze medical records to identify diagnoses, procedures, and services...

  • Retirement Operations Analyst

    1 month ago

    Jersey City, United States Retirement Operations Analyst Full time

    Our Client a well Known Investment Bank is seeking a Retirement Operations Analyst in their Jersey City, NJ location! Responsibilities:Address and resolve customer inquiries related to retirement operations, including contributions, distributions, account conversions, recharacterizations, and state withholding reconciliations.Perform data analysis and ensure...

  • Retirement Operations Analyst

    1 month ago

    Jersey City, United States Retirement Operations Analyst Full time

    Our Client a well Known Investment Bank is seeking a Retirement Operations Analyst in their Jersey City, NJ location! Responsibilities:Address and resolve customer inquiries related to retirement operations, including contributions, distributions, account conversions, recharacterizations, and state withholding reconciliations.Perform data analysis and ensure...

  • Senior Financial Analyst

    4 hours ago

    Kansas City, Kansas, United States NorthPoint Search Group Inc Full time

    Senior Financial AnalystNorthPoint Search Group Inc is seeking a highly skilled Senior Financial Analyst to join our team. As a Senior Financial Analyst, you will be responsible for providing financial leadership and support to our organization.Key Responsibilities:Develop and maintain advanced financial reports for internal stakeholders.Run data queries and...

  • Senior Financial Analyst

    2 weeks ago

    Kansas City, Missouri, United States Spring Venture Group Full time

    Job Title: Senior Financial AnalystAt Spring Venture Group, we are seeking a highly skilled Senior Financial Analyst to join our Financial Planning and Analysis (FP&A) team. As a key member of our team, you will play a critical role in driving business growth and success through data analysis, financial forecasting, and financial modeling.Key...

  • Senior SAP Business Solutions Analyst

    6 days ago

    Kansas City, Missouri, United States IDR Healthcare Full time

    Senior SAP Business Analyst Job DescriptionIDR Healthcare is seeking a highly skilled Senior SAP Business Analyst to join our team in the manufacturing industry. As a Senior SAP Business Analyst, you will play a crucial role in gathering business requirements and transforming them into SAP business application processes that can be implemented and...

  • Senior Business Intelligence Analyst

    7 days ago

    Kansas City, Missouri, United States Gallagher Full time

    Job Title: Senior Business Intelligence AnalystWe are seeking a highly skilled Senior Business Intelligence Analyst to join our team at Gallagher. As a key member of our business intelligence team, you will be responsible for generating hypotheses, quantitatively testing them, and identifying opportunities for specific companies to get workers back to work...

  • Senior Data Analyst

    3 weeks ago

    Kansas City, Missouri, United States CRB Full time

    Job Title: Senior Data AnalystCRB is seeking a highly skilled Senior Data Analyst to join our team. As a Senior Data Analyst, you will play a critical role in delivering data-driven insights to support business decision-making.Job SummaryThe successful candidate will have a strong background in data analysis, business intelligence, and data visualization....

  • Senior Business Systems Analyst

    3 weeks ago

    Oklahoma City, Oklahoma, United States Shutterfly Full time

    Senior Business Systems Analyst and Software Engineer OpportunitiesWe are seeking highly skilled professionals to fill two exciting positions at our Tempe, AZ location.Senior Business Systems Analyst (#HP-1031)This 100% telecom position offers a competitive salary of $125,278 per year and reports directly to our Tempe, AZ office.Software Engineer...

  • Senior Business Systems Analyst

    3 weeks ago

    Oklahoma City, Oklahoma, United States Shutterfly, LLC Full time

    Job Opportunity at Shutterfly, LLCWe are seeking a highly skilled Senior Business Systems Analyst or Software Engineer to join our team in Tempe, AZ.The successful candidate will be responsible for:Designing and implementing business systems and software solutionsCollaborating with cross-functional teams to drive business outcomesProviding technical...

  • Senior School Business Analyst

    2 weeks ago

    Kansas City, Missouri, United States Kansas City, MO School District Full time

    Job Title: Senior School Business AnalystJoin the Kansas City, MO School District team as a Senior School Business Analyst, responsible for performing business service functions for local funds collected and disbursed at assigned school sites.Key Responsibilities:Adhere to established accounting procedures for student activity funds, ensuring accurate and...

  • Technical Analyst

    4 weeks ago

    Kansas City, United States Research Medical Center Full time

    Description Introduction Do you have the career opportunities as a Technical Analyst you want with your current employer? We have an exciting opportunity for you to join Research Medical Center which is part of the nation's leading provider of healthcare services, HCA Healthcare. Benefits Research Medical Center, offers a total rewards package that supports...

  • Senior Hogan Developer

    3 weeks ago

    Kansas City, Missouri, United States ECCO Select Full time

    Job Description:The Hogan Development team at ECCO Select is responsible for supporting our Core Deposits and Customer systems. These core banking systems provide real-time access to customer accounts and relationships across the enterprise.As a Senior Hogan Developer, you will collaborate with business partners and analysts to analyze the Hogan Systems...

  • Senior Budget Analyst

    3 weeks ago

    Kansas City, United States Mayvin® Full time

    Job DetailsJob Location Kansas City, MO Position Type Part Time Education Level 4 Year Degree Salary Range $53.66 - $58.00 Hourly Travel Percentage None Job Shift Day Job Category Professional Services Mayvin seeks a Senior Budget Analyst to provide expertise on several ongoing projects within the Justice Prisoner and Alien Transportation System (JPATS) of...