IEHP · 2 days ago
Coding Specialist - Product System Configuration
CA, US
Full-time
Remote
Mid Level
$34.41/hr - $44.73/hr
3+ years exp
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Responsibilities
Performs ongoing product adjudication review and coding assistance to the team by reviewing all Provider contract compensation amendments and agreements.
Conducts research for coding regulations and requirements related to Medi-Cal and Medicare benefits.
Analyzes IEHP product and encounter data to identify incomplete or inaccurate configuration and/or incorrectly billed product.
Works closely with the Product System Configuration Team, Contracting department, and Product department to provide coding support related to contracts and benefits.
Develops and maintains tracking log for Medi-Cal Local Codes and other coding crosswalks.
Assist with all regulatory, internal, external or vendor audits as required.
Notifies Product System Configuration team of new codes and regulations.
Assist in the implementation and maintenance of coding rules to be administered in either McKesson or Meditrac.
Codify DOFRs, contracts, and benefits.
Demonstrate a commitment to incorporate LEAN principles into daily work.
Qualification
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Required
Three (3) years of medical coding experience required.
AHIMA or AAPC Coding Certification required.
High School Diploma or GED required.
Knowledge of CPT, HCPCS, and ICD-10 guidelines are required.
Knowledge of coding for both Medi-Cal and Medicare services.
Knowledge of coding processes, guidelines and working knowledge of Centers for Medicare & Medicaid Services (CMS) as well as Department of Health Care Services (DHCS).
Preferred
Managed Care Coding experience preferred.
Contract coding experience preferred.
Encounter or HCC coding experience preferred.
CCS-P or CPC-P preferred.
Knowledge in clinical processes and methodology concepts as they relate to all lines of business and Part D plans is preferred.
Knowledge of product processing and/or basic system configuration processes preferred.
Knowledge of Medi-Cal local codes preferred.
Benefits
Competitive salary.
Hybrid schedule.
CalPERS retirement.
State of the art fitness center on-site.
Medical Insurance with Dental and Vision.
Life, short-term, and long-term disability options
Career advancement opportunities and professional development.
Wellness programs that promote a healthy work-life balance.
Flexible Spending Account – Health Care/Childcare
CalPERS retirement
457(b) option with a contribution match
Paid life insurance for employees
Pet care insurance
Company
IEHP
With a mission to heal and inspire the human spirit, Inland Empire Health Plan (IEHP) is one of the top 10 largest Medicaid health plans, the largest not-for-profit Medicare-Medicaid public health plan in the country, and for the fourth year in a row, certified as A Great Place To Work®.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
$32.38M2021-02-04Grant· $32.38M
Leadership Team
Susie White
Chief Operating Officer
Katherine A. Kang
Vice President, HR Strategic Initiatives and Business Partners
Recent News
2024-11-26
2024-11-26
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