Coder Review Analyst - Fully Remote

Summary

Lake Region Healthcare is seeking a Coder Review Analyst to support healthcare coding and claims operations. The role researches and corrects coding-related claims, edits, and denials; collaborates with billing staff on appeals and payer documentation; and ensures coding compliance with payer, state, and federal regulations.

Responsibilities

• The Coder Review Analyst will research, analyze, and correct coding related claim, edits and denials
• This position works closely with billing staff to create and resolve appeals, provide requested documentation to payers, and other issues that arise
• The Analyst will bring forward any possible edit opportunities within our internal systems to reduce denials, and will research and analyze payer policies ensuring our coding complies with payer, state, and federal regulations
• This position works with Coding Management, presenting educational opportunities that arise based off information attained from aforementioned regulations and any ongoing trends that may arise
• The incumbent will be responsible for applying ICD-10-CM, CPT, and HCPCS codes to claims based on guidelines and policies whether internal or external and will actively seek out educational opportunities to remain current with all regulations
• Other duties as assigned by management
• Successful completion of the pre-employment health screening process required
• Must be able to attend the work site per schedule

Skills

• Bachelors or associates in an HIM or related field with RHIA, RHIT, or CCS certification, or eligibility for obtaining RHIA/RHIT certification within six months of hire
• Ability to communicate effectively both orally and in writing
• Ability to operate computer equipment
• Experience in coding

Qualifications

Must Haves

• bachelors or associates in an HIM or related field with RHIA, RHIT, or CCS certification, or eligibility for obtaining RHIA/RHIT certification within six months of hire
• Ability to communicate effectively both orally and in writing
• ability to operate computer equipment

Nice to Haves

• experience in coding

Benefits

• Fully remote work for candidates in Minnesota, North Dakota or South Dakota
• Medical and dental coverage
• HSA, FSA and 401k plans
• EAP, life and disability coverage
• Voluntary accident, critical illness and hospital indemnity coverage
• Pet insurance, ID theft protection and legal services
• For new employees, the effective date of coverage for most plans is the first of the month, following a 30-day waiting period.