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Blue Shield of California · 2 months ago

Clinical Coding Analyst, Experienced

California, United States

Full-time

Hybrid

Entry, Mid Level

1+ years exp

Blue Shield of California is a nonprofit organization committed to transforming healthcare to be more affordable and of higher quality. As a Clinical Coding Analyst-Experienced, you will ensure coding standards and compliance, implement governance frameworks, and collaborate with teams to enhance software quality and security.

Financial ServicesHealth InsuranceNon Profit

H1B Sponsor Likely

Responsibilities

Provide expert input to quarterly and annual industry standard code maintenance for multiple systems

Research and prepare benefit files using industry standard codes that meet the intent of member benefit language and/or contracts, and regulatory mandates set forth by the state or federal agencies

Develop payment policies based on industry or content expert-supported research

Provide problem management recommendations on correct application of payment and benefits based on industry and internal research

Conduct research and provide recommendations on industry standard editing for appropriate application in the current system in accordance with Blue Shield of CA payment policies and regulatory guidelines

Collaborate with cross-functional departments to implement code governance framework

Qualification

AHIMA Certified CCSCSS-P certificationProvider billing experienceClaims processing experienceMicrosoft ExcelMicrosoft WordMicrosoft PowerPointTechnical abilities

Required

Requires a minimum of an AA degree

AHIMA Certified CCS

Possess deep technical abilities

Work history in one of more of the following: 2 to 3 years of Provider billing experience in a lead, supervisory or management role; or 1 to 2 years in a payor environment working directly with payment quality and accuracy in a claims processing, providing contracting or audit capacity or; 1 to 2 years in a compliance or audit function within a health care system

Requires broad theoretical job knowledge typically obtained through advanced education

Intermittent proficiency in Microsoft Excel, Word and Powerpoint

Preferred

Bachelors' degree preferred

Preferred certification as CSS-P

Company

Blue Shield of California

Glassdoor3.8

Blue Shield of California is a health insurance service provider.

Founded in 1939

San Francisco, California, USA

5001-10000 employees

https://www.blueshieldca.com

H1B Sponsorship

Blue Shield of California has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2023 (1)

2022 (41)

2021 (20)

2020 (31)