Blue Shield of California · 1 day ago
Clinical Coding Analyst, Experienced
California, United States
Full-time
Hybrid
Mid, Senior Level
1+ years expBlue Shield of California is a nonprofit organization focused on transforming healthcare to improve quality and affordability. The Clinical Coding Analyst will ensure coding standards and compliance while collaborating with cross-functional teams to implement a code governance framework.
Financial ServicesHealth InsuranceNon Profit
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
Required
HS Diploma or equivalent required; AA degree preferred
AHIMA Certified CCS required
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
Preferred certification as CCS-P
Company
Blue Shield of California
Blue Shield of California is a health insurance service provider.
5001-10000 employees
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)
Funding
Current Stage
Late StageLeadership Team
Gary Culp
Senior Vice President, Government Markets
Gregory Siebert
Senior Vice President Provider Partnerships & Network Management
Recent News
2026-01-13
Fierce Healthcare
2025-12-15
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