Blue Cross and Blue Shield of Minnesota · 1 day ago
Healthcare Coding Analyst
Blue Cross and Blue Shield of Minnesota is committed to transforming healthcare and is seeking multiple Healthcare Coding Analysts. In this role, you will ensure healthcare medical coding and reimbursement policies are accurately implemented and assist with data analysis and reporting related to coding policy decisions.
Insurance
Responsibilities
Conduct in-depth research and analysis of appeals data and processes to identify trends and emerging issues, and recommend best practices for maximum performance
Research and recommend resolution and/or prepare written response for provider related coding appeals assuring that federally and state mandated coding rules are followed and that the medical documentation supports such coding
Provide recommendations to leadership to modify reference materials and processes that do not fully satisfy regulatory or legal compliance related to coding
Provide recommendations to modify materials and processes that do not accurately follow our internal policies and contracted agreements or that have proven to be confusing or ineffective
Complete follow-up activities to reflect change for compliance
Assist in communicating changes in Blue Cross coding and reimbursement policies to all lines of business, internal business teams and contracted providers
Maintain Blue Cross Provider Policy and Procedure Manual relative to coding policy decisions and related reimbursement
Serve as a liaison to other divisions/departments (Health Management, Service, Claims) for coding policy and coding/payment issues
Directs and coordinates activities of designated coding projects through the project life cycle including the needs assessment, project initiation, design, development and implementation
Serve as a knowledge expert related to medical coding
Participate as a team member of cross-departmental committees (e.g. Coding and Reimbursement, RICHIE, NAG, I-team)
Qualification
Required
2+ years' related experience or Bachelor's degree. All relevant experience including work, education, transferable skills, and military experience will be considered
3 years of relevant health plan or provider office medical coding/claims and/or Business Analyst experience in a healthcare setting applicable to claims/coding
Have at least one of the following credentials – CPC, CCS, CCS-P, RHIT
Incumbent is expected to enroll in continuing education courses to maintain certification
Ability to apply critical thinking skills to coding policy interpretation and implementation
Ability to work independently; well-organized and able to set priorities with minimal direction
Ability to effectively communicate both verbally and in writing
Strong PC skills; Excel, Word, PowerPoint and internet based programs
Ability to maintain relationships with internal and external stakeholders, coding experts, and others
High school diploma (or equivalency) and legal authorization to work in the U.S
Preferred
Associates degree
Benefits
Medical, dental, and vision insurance
Life insurance
401k
Paid Time Off (PTO)
Volunteer Paid Time Off (VPTO)
And more
Company
Blue Cross and Blue Shield of Minnesota
About Blue Cross Blue Cross and Blue Shield of Minnesota is a taxable, nonprofit organization with a mission to make a healthy difference in people’s lives.
H1B Sponsorship
Blue Cross and Blue Shield of Minnesota 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
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Trends of Total Sponsorships
2025 (4)
2024 (4)
2023 (6)
2022 (2)
2021 (3)
2020 (5)
Funding
Current Stage
Late StageLeadership Team
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