The Coding Analyst I for SelectHealth provides expertise across professional, facility, drug, DME, and lab code sets for government insurance programs and self-funded plans. The role reviews claims and monitors provider appeals, including provider correspondence, while supporting accurate coding, reimbursement, compliance, and regulatory adherence.
Key responsibilities include:
- Reviewing pre-payment claims to monitor billing practices and ensure accurate coding and reimbursement
- Ensuring review decisions align with ERISA standards
- Logging provider appeals and sending correspondence
- Consulting with internal departments, physicians, and facilities
- Supporting higher-level analysts with research and workflow management
- Maintaining subject-matter expertise and educating providers and staff
- Ensuring compliance with coding regulations across multiple provider specialties and claim types
Requirements & Qualifications
Minimum qualifications
- Associate degree from an accredited institution, or
- Two years of work experience in coding, healthcare, or a health plan environment
- Intermediate-level experience with Microsoft Office applications
- Excellent written and verbal communication and presentation skills
Preferred qualifications
- Bachelor's degree from an accredited institution
- National professional coding certification such as CPC or CCS, to be obtained within one year of hire
- Two years of coding or auditing experience in a professional, facility, or health plan environment
- Strong organizational, analytical, and communication skills
- Ability to build rapport with co-workers, physicians, and other healthcare providers
- Ability to work independently with minimal supervision
- Sound judgment and decision-making skills
- Experience with government programs such as Medicare, Medicaid, or ACA
Location
Utah, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
1 week ago