Healthcare Coding Analyst

About Blue Cross and Blue Shield of Minnesota

At Blue Cross and Blue Shield of Minnesota we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate you are joining a culture that is built on values of succeeding together finding a better way and doing the right thing. If you are ready to make a difference join us.

The Impact You Will Have

Blue Cross and Blue Shield of MN is hiring a Healthcare Coding Analyst in Eagan this role you will be responsible for ensuring healthcare medical coding and reimbursement policies are implemented and integrated in all systems for accurate claims adjudication. This includes analysis of changes to medical code sets to determine impacts to and necessary changes of current policies assisting with data analysis and reporting needs related to coding policy decisions and reviewing medical records to validate provider coding. The incumbent will also represent the medical coding team on various Blue Cross project teams.

The ideal candidate will have 3 years of prior coding experience and a certification in CPC CCS CCS-P or RHIT.

Your 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).

Required Skills and Experience

Preferred Skills and Experience

Role Designation

Hybrid

Anchored in Connection

Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships creativity and alignment. The rest of the week you are empowered to work remote.

Compensation and Benefits

$67200.00 - $89100.00 - $111000.00 Annual

Pay is based on several factors which vary based on position including skills ability and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include :

Medical dental and vision insurance

Life insurance

401k

Paid Time Off (PTO)

Volunteer Paid Time Off (VPTO)

And more

To discover more about what we have to offer please review our benefits page.

Equal Employment Opportunity Statement

At Blue Cross and Blue Shield of Minnesota we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to and will not be discriminated against based on any legally protected characteristic.

Individuals with a disability who need a reasonable accommodation in order to apply please contact us at :

Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.

Required Experience :

IC

Key Skills

Civil,Apparel,Banking,CMS,Insulation

Employment Type : Full-Time

Experience : years

Vacancy : 1

Yearly Salary Salary : 67200 - 111000