Benefit Intent and Coding, Senior

Your Role

The Benefit Intent team is responsible for providing the benefit coding for Commercial, Medicare and Medi-Cal lines of business. The Benefit Intent Senior Coding Analyst will report to the Senior Manager for Benefit Intent. In this role you will Perform benefit coding to support Evidence of Coverage, Medicare or Medi-Cal benefits and State or Federal Mandated benefits. This role will also provide subject matter support for benefit coding for internal and external business partners.

Your Knowledge and Experience

• Requires a bachelor's degree or equivalent experience
• Requires at least 5 years of prior relevant experience
• AHIMA Certified CCS or CSS-P required
• Generally, requires 5-8 years of directly related professional experience and possesses deep technical abilities
• Medicare experience is required (CA State Medicaid experience will be considered)
• Work history in one or more of the following:
  
  
  
  • 3 years of Provider billing experience in Medicare and California State Medi-Cal in a lead, supervisory or management role or
  • 2 years in a payor environment working directly with payment quality and accuracy in a claims processing, provider contracting or audit capacity or 2 years in a compliance or audit function within a healthcare system
  
  
• Strong level research and analytical skills into industry and internal sources
• Working knowledge of provider billing practices and standards, including in-depth knowledge of professional and facility claims processing
• Subject Matter expert in Medicare and Commercial Insurance programs requirements
• Some knowledge of Health Care Reform/ACA mandate requirements
• Strong writing and communication skills
• Able to independently use Microsoft Office products (Excel, Word, Outlook, Access)