Coding Analyst Resume Sample
Asha Shanahan
381 Lemuel Highway,
Dallas,
TX
+1 (555) 652 1609
Work Experience
Senior Coding Analyst
12/2015
-
PRESENT
Phoenix, AZ
- Working knowledge and experience in analyzing, detecting and investigating health insurance fraud, waste, and abuse
- Knowledge of the healthcare industry; fraud, waste and abuse audit operations, and claims and payment processing
- Proficient use of applicable software programs, including Microsoft Word, Excel, Access, and PowerPoint required
- Organized and detail oriented with strong problem solving skills
- Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer
- Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
- Responsible for leading and supporting the department teammates, supervisor and manager to ensure that appropriate Coding for reimbursement and HCC’s conforms to applicable guidelines and regulations
- Perform medical chart audits to assure that codes billed are appropriate and supported by documentation in the patient’s record with the appropriate CPT, HCPC or ICD-10 code
- Project management, build, and implementation of Healthy Planet
Coding Analyst
07/2009
-
10/2015
Dallas, TX
- Independently perform analysis of high risk and/or high dollar claims on a pre-payment basis utilizing coding and medical records analysis to ensure claims are neither over nor underpaid
- Request and independently review pertinent medical documentation to validate/invalidate potential issues identified on high risk/complex claims
- Determine claim level financial impact based on unique member benefits and provider contract terms, rates and payment policies
- Ensure claims processing compliance with overarching administrative regulations (Federal, State of Florida, BCBS Association, etc.)
- Coordinate and communicate directly with provider personnel as necessary to understand and communicate identified coding/billing discrepancies
- Thoroughly document identified issues to support claim adjustments(including supporting medical documentation or coding rationale) and process gaps driving incorrect payment for remediation and prevention
- Current and active coding certifications with American Association of Professional Coders (anyone of the following: AHIMA, CPC, CCS, etc.)
Junior Coding Analyst
08/2005
-
03/2009
Philadelphia, PA
- Develop action plans and provide direct report with updates on implementation progress
- Assist in the resolution of production environment needs for tools and process related with the application
- Assists users in answering questions to ensure the applications are properly used in conjunction with their business process
- Assists compliance analysts in educational process and audit tools used in HCC review process. Supports all systems processes related to HCC coding including, but not limited to: Epic, OpTime, Radiant,Softlab, Provation, Mosaiq, in front end and post review process
- Utilizes strong proficiency of Federal, State and Commercial payor regulations in performance of audits, and uses strong communication skills to interact real time with staff and providers. Performs and communicates corrections and addendums of electronic medical records to apply HCC rules as indicated through standard work processes
- Educate physician and clinical staff on appropriate documentation as required by medical review. Provides advice to user on use of application to solve future coding needs. Documents all changes per compliance and IT standards
- Participate in special Health Plan audits and meetings related to HCC accuracy and reporting
- Serve as the liaison between EPIC IT and the CHAPS team including coding, MD champions and providers
Education
National American University - Albuquerque Campus
2001 - 2005
Bachelor's Degree in Accounting
Professional Skills
- Demonstrates strong critical thinking skills
- Excellent consulting, training, decision making, organizational and communication skills
- Strong analytical time management and decision making skills
- 4) Strong management and interpersonal skills
- Medical coding experience with strong attention to detail and a high level of accuracy in a clinical or managed care setting
- Thorough, up-to-date clinical skills, current working knowledge of pathology, pharmacology, surgical procedures, etc
- Notable client service, communication, and relationship building skills required
How to write Coding Analyst Resume
Coding Analyst role is responsible for excel, design, training, database, auditing, coding, reporting, education, research, insurance.
To write great resume for coding analyst job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Coding Analyst Resume
The section contact information is important in your coding analyst resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Coding Analyst Resume
The section work experience is an essential part of your coding analyst resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous coding analyst responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular coding analyst position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Coding Analyst resume experience can include:
- Demonstrate proficient working knowledge of the following: Medical terminology, claim audit procedures, provider contract understanding, provider billing (Institutional claims), medical coding of institutional services
- The reading skills necessary to decipher physicians’ handwriting
- Participates in continuing education activities to enhance knowledge, skills and keep credentials current
- Experience in coding or an equivalent combination of education and experience
- Four years of experience in hospital inpatient and outpatient coding required or other business related program required
- One year of coding experience required
Education on a Coding Analyst Resume
Make sure to make education a priority on your coding analyst resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your coding analyst experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Coding Analyst Resume
When listing skills on your coding analyst resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical coding analyst skills:
- Demonstrated success in working effectively both independently and as part of a team
- Strong Computer Skills (Word, Excel, & Power Point),
- At least one year of surgery coding experience and emergency department coding experience required
- Risk adjustment experience; or any combination of education and experience, which would provide an equivalent background
- Experience with multiple provider reimbursement and pricing methodologies (i.e. - DRG, SPC, OFS, POC, Global Pricing, Per Diem, etc.)
- Healthcare and medical claims processing experience within a provider/facility’s office or Payer
List of Typical Experience For a Coding Analyst Resume
1
Experience For Senior Coding Analyst Resume
- Strong knowledge of coding clinics and how to obtain education information
- Interim coding and Validate / Recode. Process Rebills as appropriate
- Excellent abilities with regard to attention to detail and accuracy
- Generally, requires 5-8 years of directly related professional experience and possesses deep technical abilities
- Creating and maintaining Staples product database to enable bid and margin teams to provide a comprehensive bid response including stock alternatives
- Ongoing quarterly review of medical record documentation, for coding and documentation compliance
- Understanding of appeal process with knowledge how to speak to denial and/or appeals
- Educate and provide coding and billing guidance on all new or revised coding for drugs, technologies and procedures
2
Experience For Quality / Education Coding Analyst Resume
- Functions as Lead Coding Advisor to HIS Coding Specialists (90%)
- Performs training and quality monitoring of new employees and students
- Have secondary responsibility in supporting global job scheduling infrastructure
- Support testing to verify benefit coding performs as designed
- Use reporting systems to identify areas for focused chart audits, i.e. Downcodes, Nonbillables, procedural coding, etc
- Responds to and resolves in a timely manner production issues related to coding issues
- Responds to coding denials from payers
3
Experience For Medical Coding Analyst Resume
- Performs random coding quality review on a quarterly basis
- Assists when needed with abstracting Medical Records to identify, sequence, and code diagnostic and procedural information timely and accurately
- Works Quadax claims, EBEW reports, and pending reports to facilitate cases get processed timely and accurately
- Develop scripts, including data encryption, when required
- Provides recommendations to internal and external customers as benefit intent coding subject matter expert
- Previous customer-facing role/responsibilities
4
Experience For M HIS Coding Analyst Resume
- Maintains reporting of activities
- Reviews patient charts to identify opportunities for improved clinical documentation and/or accuracy in provider driven coding
- Investigate denial claims related to coding, LCD/NCD and medical necessity
- Works to resolve workflow, systems and complex matters related to coding
- Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity accounts
- Adhere to and maintain required levels of performance in both coding quality and productivity as established by Optum360
- Understand federal coding register and ensure guidelines are used and followed appropriately
- Code Updates: Ensure quarterly and annual CPT, HCPC, and ICD-10 codes are updated
5
Experience For FTP Coding Analyst Resume
- Communicate clinical’s position on resource and timeline needs for assigned documents to project team members, negotiating as needed with the team on these matters and keeping line management informed
- Participate in communication and education with medical staff concerning documentation issues to support accurate coding and billing
- Work with large files for coding and cross referencing acquired companies’ product data
- Accurately code and enter diagnoses and procedures for discharged inpatient medical records within appropriate timeframes to meet timely billing requirements
- Accurately code and enter diagnoses and procedures for admission (interim) claims within appropriate timeframes to meet timely billing requirements
- Assist with any coding or compliance audits, as needed
- If assigned by manager, serve as the clinical ‘point of contact’ for all document issues for a given product or set of products
6
Experience For Lead Medical Coding Analyst Resume
- Answer questions pertinent to ICD-10 guidelines
- Code outpatient records as needed
- Maintain and support FTP gateway systems infrastructure and jobs as part of a team
- Design automated data transfer solutions
- Work through CBO Review work file ensure complete and accurate information for assigned visit, referring MD, NDC#s for any NOC drug, matching ordering MD vs MD1
- Previous experience with insurance claims or electronic health records data
7
Experience For Epic Coding Analyst Senior Resume
- Assist in branch closings by ensuring accounts are moved to designated branches {Evansville, IN}
- Abstracts pertinent information from patient records. Assigns the International Classification of Diseases, Clinical Modification (ICD), Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding System (HCPCS) codes, creating Ambulatory Patient Classification (APC) or Diagnosis-Related Group (DRG) assignments
- Analyzes progress notes and documentation sent by providers for validation following CMS guidelines and ICD-9 / ICD-10 Coding Manual guidelines and enters final results into appropriate tab of the DataRAP® database
- Responsible for supporting the bid and margin teams by creating and maintaining master trans codification tables and associated tooling repository by liaising with merchandising teams across segments both locally and centrally
- Creating lines of communication with key stakeholders to enable competitor tables to be updated swiftly, providing the bid and margin teams with the best possible competitive view and advantage when creating bids and QBRs
- Provides expert input to quarterly and annual industry standard code maintenance for multiple systems in support of product and benefit impacts
- Researches and prepares benefit files using industry standard codes that meet the intent of the benefit language for internal documents such as; Evidence of Coverage documents, legislative (state and federal) mandates, Summary of Benefits or other health plan documents
- Researches and respond to support benefit intent questions during plan design
- Provides Product and Benefit support as required for the development of payment or medical polices when there are impacts to benefits
8
Experience For Healthcare Coding Analyst Resume
- Provides problem management recommendations on correct application of benefits intent based on industry and internal research
- Manage Provider Manual content and support communication related to product and benefit intent as assigned
- Perform updates to the internal software/ applications for benefits as needed
- Complete regular updates to Benefit Policies as changes occur
- Assist with GAT ad hoc requests for data
- Tracks and manages documentation indicators of each practice
- Identifies providers who could benefit from documentation education
- Compiles chart samples, where the documentation was lacking some key billing components, that are used as educational tools for both one-on-one and the monthly Documentation Champion calls
- Coordinates documentation education sessions
9
Experience For Associate Benefits Coding Analyst Resume
- Continually identifies opportunities for revenue improvements
- Gather chart examples and general documentation issues for the purpose of educational feedback to be provided by Director(s) of Documentation Education
- Collaborate with clinical departments, Compliance, Quality and Revenue Cycle to improve any process gaps identified in front end charge capture processes
- Monitors assigned work queues and reviews accounts for denials
- Assists Revenue Cycle with collection of clinical/medical necessity documentation
- Serve as a resource for authorization/referral process, as appropriate
- Prepares and distributes denials prevention and recovery related reports
- Performs diagnosis data submissions to Client, Vendors and internal Stakeholders
10
Experience For Senior Health Care Coding Analyst Resume
- Develop monthly productivity and revenue projections
- Audit diagnosis submission files to ensure accuracy
- Prepares data collection reports for leadership
- Monitors diagnosis submission progress
- Analyze diagnosis data to improve submission quality (Chart Review Delete Process)
- Identify appropriate assignment of ICD-10-CM and ICD-10-PCS Codes for inpatient services provided in a hospital setting and understand their impact on the DRG with reference to CC/MCC, while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
List of Typical Skills For a Coding Analyst Resume
1
Skills For Senior Coding Analyst Resume
- Entry Rate: $16.15 or more, depending on experience
- Proven ability to review, analyze, and research coding issues
- Five years’ experience in coding, medical records and reimbursement
- Two years’ experience in coding, medical records and reimbursement
- Previous experience working in a managed care environment
2
Skills For Quality / Education Coding Analyst Resume
- At least one year of coding experience
- Five years experience in coding, medical records and reimbursement
- Reviews claim and medical record documentation to validate improper payments
- Experience coding hospital medical claims
- Experience working within a health care provider organization or health insurance company
- Experience with OSHPD reporting
3
Skills For Medical Coding Analyst Resume
- Experience coding hospital medical claims
- Experience with various risk adjustment methodology and chart audits
- Physician and hospital medical claims experience
- Reimbursement policy and/ or claims software analyst experience
- 5)Demonstrated ability to partner with physicians and provide feedback on medical documentation best practices
- Understanding of relevant technical aspects of Claims Edit software and solutions
- Assesses coding training needs of the physicians. Conducts training sessions on all aspects of proper coding and documentation for all physicians
4
Skills For M HIS Coding Analyst Resume
- Researches coding issues that arise, and reports areas of risk directly to the Manager of Physician Coding Education
- Acts as the primary coding expert/resource for all TUFTS MC P.O. physicians, their billing staff and Reimbursement Department staff
- Suggests coding process improvements for optimal coding and reimbursement
- Consistently abides by the Standards of Ethical Coding as set forth by the AHIMA and adheres to official coding guidelines
- Knowledge of ICD 10, CPT and related coding/abstracting rules and guidelines
- Knowledge of various loan types such as Interest bearing, pre-compute and revolving
- Certified Procedural Coder (CPC) or Certified Coding Specialist (CCS) or Certified Coding Specialist for the Physician (CCS-P)
5
Skills For FTP Coding Analyst Resume
- Proficiency in medical coding and use of various research manuals and guidelines used to render decisions
- Proficiency in medical coding and use of various research manuals and guidelines
- Performs focused reviews and provides results to the Coding Education Specialist team
- Inputs all governmental reviews in AudaPro, including audit outcomes
- Runs AudaPro reports to analyze trends, and utilizes results to recommend appropriate education and/or training
- Performs charge corrections via CSLink billing system as appropriate
- Assists in preparing audit reports as necessary
- Participates in meetings, training and conference calls as requested
- Participates in workshops, seminars, audio conferences and other educational opportunities to ensure continued learning for self-improvement
6
Skills For Lead Medical Coding Analyst Resume
- Reviews CPT and ICD-9 coding relationships and reports findings to physicians
- Participates in personal annual performance evaluation, providing opportunity for growth and development
- Nationally recognized coding credential required: RHIA, RHIT, CCS-P, or CPC
- 2)In-depth knowledge of medical terminology, disease processes, patient health record content and the medical record coding process
- 3)Knowledge of principles, methods, and techniques related to compliant healthcare billing/collections
- Certified Coding Specialist - Professional (CCS-P)
- Knowledge of refunding methods such as Rule of Anticipation, Actuarial and Rule of 78s
- Follow detailed instructions on new assignments
- Determines claim appeal process as appropriate
7
Skills For Epic Coding Analyst Senior Resume
- Monitors all published reviews by Noridian
- Ensures audit timelines for all audit types are followed accordingly
- Communicates with providers to obtain documentation clarification
- Monitors Medicare rules for updates and changes
- Develops and administers a detailed, comprehensive education program to ensure physician compliance with third party Evaluation & Management (E & M) documentation requirements. Educates Coding Physician Liaison staff in fundamental E & M documentation guidelines
- Monitors all third party coding-related correspondence and specialty related coding newsletters to ensure Tufts MC P.O. physicians remain current on all CPT and ICD-9 coding development
- Contacts physicians to discuss denials and to obtain additional documentation as required
- Maintains frequent and regular contact with supervisor and seeks consultation and guidance when appropriate
8
Skills For Healthcare Coding Analyst Resume
- Strong background across a wide range of medical record review processes, including: Evaluation and management, anesthesia, surgical services, radiology, pathology and medicine. Sound knowledge of: CCI (Correct Coding Initiative), insurance regulations (i.e., Medicare, Labor and Industries, Welfare) and regulatory compliance issues
- 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
- Medical coding experience with strong attention to detail and a high level of accuracy in a clinical or managed care setting
- Assist in communicating changes in Blue Cross coding and reimbursement policies to all lines of business, internal business teams and contracted providers
- Serve as a liaison to other divisions/departments (Health Management, Service, Claims) for coding policy and coding/payment issues
- Maintain Blue Cross's Provider Policy and Procedure Manual relative to coding policy decisions and related reimbursement
9
Skills For Associate Benefits Coding Analyst Resume
- 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)
- Effectively communicate both verbally and in writing. · Strong PC skills; Excel, Word, PowerPoint and internet based programs
- Apply critical thinking skills to coding policy interpretation and implementation
- Relevant health plan or provider office medical coding/claims and/or Business Analyst experience in a healthcare setting applicable to claims/coding
- Demonstrated understanding of GEIIDX automated billing system and third party reimbursement of professional services
- Experience coding hospital medical claims
- Maintain relationships with internal and external stakeholders, coding experts, and others
- Professional coder certification with credentialing from AHIMA and/or AAPC (CCS, RHIA, RHIT) to be maintained annually
10
Skills For Senior Health Care Coding Analyst Resume
- Use a PC in a Windows environment, including MS Excel and EMR systems
- Successful completion of the CPC, CPC-H or CPC-P exam no later than 6 months after hire
- Beginner level proficiency with SQL, SAS and/or other statistical programs
- Current certification as a professional coder (RHIA, RHIT, CCS, CPC-A, CPC)
- The addition of CCS-P, CCS-H, CPC-P and CPC-H certification
- Intermediate knowledge of OCE, MUE and NCCI classification and reimbursement structures
- Experience working in a level I trauma center and/or teaching hospital with a mastery of complex procedures, major trauma ER encounters, cardiac catheterization, interventional radiology, orthopedic and neurology cases, transplant, and observation coding
- Experience with various encoder systems (eCAC,3M, EPIC)
List of Typical Responsibilities For a Coding Analyst Resume
1
Responsibilities For Senior Coding Analyst Resume
- Process and/or review claims in a timely manner utilizing client specific coding and billing requirements that meet or exceed production and quality goals
- Collaboration with other MSH departments to provide coding and billing guidance and support
- Review, research and respond to practice billing and coding questions
- Documents coding review findings within investigative case tracking system and maintains thorough and objective documentation of findings
- Serves as a coding resource and provides coding expertise and guidance to entire investigation and/or clinical team
- Process electronic coding requests through the company operating system
- Assist payer audit team with responses to payer audits including but not limited to RAC, CERT, ZPIC, SMRC, and commercial payers
- Work history in one or more of the following
2
Responsibilities For Quality / Education Coding Analyst Resume
- Communicates determinations verbally and/or in writing to appropriate business department as required by department internal workflow policies
- Computer proficiency required, including data entry of adverse event information into standardized electronic databases such as ARISg/ARGUSSearch Jobs US
- Acquisition support – cross-referencing acquired companies’ supplier and item information
- Track and report daily, weekly, and monthly coding activities
- Provide guidance related to government regulations and commercial payer policies
- Prepare material through research of payer guidelines for claims denials and assist other departments with claims appeal responses
3
Responsibilities For Medical Coding Analyst Resume
- Upon request, support network practices with review of medical record documentation, including but not limited to evaluation and management, medical and radiation oncology, genetic counseling, clinical research, surgical and other specialties
- Provides feedback and education on documentation, coding and billing
- Provides support and guidance for new In Market Affiliation (IMA) chart reviews
- Conduct, participate and provide support in practice and USON committee calls
- Lead designated subject matter expert (SME) initiatives
- Provides expertise in support of the application of the industry standard codes for benefit design or benefit coding specific to Medicare and California State Medi-Cal
- AHIMA Certified CCS or CSS-P required
- Conducts coding reviews of medical records and supporting documentation against submitted claims, for individual provider and facility claims, to determine coding and billing accurate for all products
4
Responsibilities For M HIS Coding Analyst Resume
- Monitors, tracks and reports on all case work
- Participates in process improvement activities and encourages ownership of and group participation in improvement initiatives
- Analyze medical documents to evaluate potential issues of fraud and abuse
- Coordinate activities with varying levels of leadership, investigative team, legal counsel, internal and external customers, law enforcement and regulatory agencies, and medical professionals through effective verbal and written communications
- Monitor CMS and major payer coding and reimbursement policies
- Researches and interpret correct coding guidelines and internal business rules to respond to customer inquiries
- Analyze and research product to determine and maintain interchangeability
- Create and maintain internal stock numbers and all data elements associated with transactional information such as (part #s, description, taxonomy, unit of measure, keywords, etc.)
5
Responsibilities For FTP Coding Analyst Resume
- Work with large data files for product identification and new product induction into the Motion operating system
- Create and maintain supplier/manufacturer information such as (company names, addresses, phone #s, contacts, etc.)
- Assist branches with operational questions as needed
- Proficiency in Microsoft Office (Outlook, Access, Word, PowerPoint – high proficiency in Excel is required)
- Listen to branch needs and troubleshoot for a solution
- Handle sensitive material and practice data governance standards
- Abstracts relevant clinical and demographic information from
6
Responsibilities For Lead Medical Coding Analyst Resume
- Abstracts relevant clinical and demographic information from the medical record to assign ICD-9 and CPT-4 codes in accordance with coding and reimbursement guidelines
- Research and prepare benefit files using industry standard codes that meet the intent of the benefit language for internal documents such as; Medicaid & Medicare Provider Manual, Evidence of Coverage documents, legislative (state and federal) mandates, Summary of Benefits or other health plan documents
- Research and respond to support benefit intent questions during plan design. Provides Product and Benefit support as required for the development of payment or medical polices when there are impacts to benefits
- Four years of experience in hospital inpatient and outpatient coding required
- 5+ yrs. experience in OP Coding,
- Generally requires 5-8 years of directly related professional experience and possesses deep technical abilities
7
Responsibilities For Epic Coding Analyst Senior Resume
- Provide recommendations to internal and external customers as coding subject matter expert
- Completion of a HIT or Coding program required
- Transfer of WQ Data to Coding Scorecards for educational purposes
- Other Projects as designated by Coding Leadership. AA/EOE
- AAPC or other specialty coding certification
- Provide problem management recommendations on correct application of benefits intent based on industry and internal research
- Perform audits to identify trends for educational opportunities: Health Lab, Ancillary OP (Outpatient), DAR (Departments Appt. Report), SVC (Simple visit Coding)
- Assists in the preparation and formatting of IP Audit Report results from vendors
- Act as a resource to OP Coders
8
Responsibilities For Healthcare Coding Analyst Resume
- Develops relationships across the organization to identify and secure interdepartmental support for account resolution
- Analyze reports to support educational needs and attain department goals
- RHIT, RHIA, or CCS,
- Able to maintain professionalism and a positive service attitude at all times
- Certified Medical Code (CPC or CCS) required
9
Responsibilities For Associate Benefits Coding Analyst Resume
- 1)Knowledge of professional/physician coding rules for inpatient, hospital outpatient, clinic, and/or emergency settings. Experience with National Correct Coding Initiative edits (NCCI), National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and Outpatient coding guidelines for official coding and reporting
- Successful completion of AAPC certified professional coder examination required
- Certified Professional Coder - Hospital (CPC-H)
- Certified Outpatient Coder (COC)
- Outpatient or Professional Fee Coding: Registered Health Information Technician (RHIT) , Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Coding Specialist - Professional (CCS-P) or Certified Professional Coder - Hospital (CPC-H)
- Analytical – able to build complex spreadsheets to support the role
10
Responsibilities For Senior Health Care Coding Analyst Resume
- Industry product knowledge desirable
- 6) Ability to work independently
- Serve as consultant to Claims Operations, Utilization Management, Training and Auditing and other areas as needed to assist with review of billing/coding issues
- Runs queries on claims, diagnosis codes, providers and procedure codes. Logs provider appeals and runs quarterly reports on this data. Maintains Access database for appeals. Types and prints all customized letters sent to providers
- Provides limited support to the Behavioral Health Department. Including running reports and sending out daily letters
- Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; is regarded a san expert in the technical/functional area; accesses and uses other expert resources when appropriate
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