Richmond County, VA, USA
The Benefits Coding Analyst – Certified Professional Coder maintains the integrity of the plan benefits for each program and is responsible for developing an extensive expertise of all plan benefits. The Benefits Coding Analyst will work closely with multiple teams across the Health Plan, including but not limited to Claims, Compliance, Program, IT, and Health Services/Medical Management to ensure benefits are compliant with State and Federal guidelines, as well as aligned with Program benefit offerings. This position is responsible for synthesizing the input from multiple stakeholders to inform significant business decisions regarding benefit implementation as well as coordinating and maintaining benefit design documentation for the organization. Qualifications Education Level Bachelor’s Level Degree Experience Required: Coding – Previous experience, Medicaid – Previous experience, Medical Terminology – Previous experience, Medicare – Previous experience, Medicare/Medicaid Billing – Previous experience Preferred: None, unless noted in the “Other” section below License Required: None, unless noted in the “Other” section below Preferred: Cert Coding Associate, Cert Coding Specialist Skills Required: Preferred: None, unless noted in the “Other” section below Other 3 years of experience in healthcare sector (preferably Medicaid Managed Care and/or Medicare) and claims. Demonstrated experience interpreting state and federal contracts. Knowledge of CPT, ICD-10 and HCPCS coding system, and CMS 1500/UB04 billing preferred.