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Healthcare Coding Specialist
2 months ago
Insight Global is seeking a skilled Healthcare Coding Specialist to join our Medical Policy team.
This role involves collaborating with clinical professionals, including physicians and research analysts, to articulate the language of medical policies.
Once the medical policy is drafted, the specialist will review the document and apply relevant medical codes (including procedure, revenue, and modifiers) based on their understanding of the policy's language.
Key responsibilities include:
Primary Duties:
- Partnering with the medical team to create a comprehensive list of codes and policies (over 800+ policies). The specialist will manage approximately 35 to 40 policies and collaborate with 2-3 research analysts, nurses, or doctors.
- Developing code lists for benefit applications, mandate applications, and group exception requests.
- Collaborating closely with various departments, including Legal, Sales and Marketing, and Product Operations.
- Reviewing coding resources to recommend and develop thorough listings of appropriate codes in line with coding guidelines and national standards.
- Revising coding within policies based on recommendations from committees, management, or medical directors.
- Serving as a resource for company associates regarding medical coding inquiries related to departmental documents and projects.
At Insight Global, we are dedicated to fostering diverse and inclusive workplaces where individuals can express their authentic selves every day. We are an equal opportunity/affirmative action employer, committed to ensuring that all candidates receive fair consideration for employment regardless of race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other characteristic protected by applicable laws and regulations.
If you require assistance or reasonable accommodations due to a disability during the application or recruitment process, please reach out for support.
Qualifications:
- Bachelor's degree
- 4+ years of experience as a Medical Coder, with a focus on inputting codes and adding procedure codes, modifiers, and revenue codes.
- Experience collaborating with physicians to draft claim policies in accordance with coding guidelines (coding charts, not just pulling codes).
- Background in coding across multiple specialties, including radiology, OBGYN, pathology, surgery, anesthesia, and emergency medicine.
- 4+ years of professional coding experience (NO facility coding).
- MUST RESIDE IN NJ, PA, OR DE; candidates from other states will not be considered.
- Active coding certification is required (CCS or CPC preferred).
