Job Description:
Claims Solution Coders utilize their professional coding expertise and knowledge of the professional revenue cycle to perform coding abstraction, reviews, and final validation of complex professional claims. They resolve issues requiring coding expertise, mentor Claims Solution Specialists, and collaborate with clinic leadership, providers, and billing colleagues to enhance the efficiency and accuracy of the professional claims process.
Our Claims Solution Specialist – Coders leverage their professional coding expertise and understanding of the professional revenue cycle to perform coding abstraction and reviews, and final validation and resolution of complex professional claims issues requiring coding expertise. They provide mentorship to Claims Solution Specialists, and engage clinic leadership, providers, and other billing colleagues to participate in the continuous improvement efforts focused on increasing the efficiency and accuracy of the professional claims process.
Essential Functions
- Resolve Advanced Claims Issues: Utilize certified coding expertise to address and resolve complex claims issues.
- Mentor and Support: Guide and assist Claims Solution Specialists in their daily duties, providing mentorship and support.
- Design Support Tools: Develop tools and resources to aid Claims Solution Specialists in their responsibilities.
- Provide Training and Helpline Support: Conduct training sessions and answer questions through the coding helpline.
- Design Standing Orders: Create standing orders to enable the management of claims by individuals without coding experience or certification.
Skills
- Medical Insurance Coding
- Medical Billing and Coding
- Claims Processing
- Claims Management
- Claims Resolution
- Insurance Industry
- Computer Coding
- Healthcare
- Billing
- Medical Billing
Minimum Qualifications
- CPC coding certification.
- Professional coding experience or medical billing experience.
Preferred Qualifications
- Advanced coding knowledge (e.g., CCI edits, appeal management)
- Root cause analysis experience
Physical Requirements:
Physical Requirements
- Ongoing need for employee to see and read information, labels, documents, monitors, identify equipment and supplies, and be able to assess customer needs.
- Frequent interactions with providers, colleagues, customers, patients/clients and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.
- Manual dexterity of hands and fingers to manipulate complex and delicate supplies and equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc.
Location:
Avenues Physician Tower
Work City:
Salt Lake City
Work State:
Utah
Scheduled Weekly Hours:
40
The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$22.64 - $34.48
We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Learn more about our comprehensive benefits package here.
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.
All positions subject to close without notice.
