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Job Title: Coding Analyst

Type: Contract

Compensation:

Contractor Work Model: Remote

Hours: Add the job’s scheduled days and times (delete if not needed)

Security Clearance: List security clearance requirements (delete if not needed)

Title: Coding Analyst

ALTA is supporting an 6-month contract opportunity working 100% remote.

ALTA Recruiting Team: Need resume with ALTA logo along with candidate's current location (state/zip), no phone number and email address needed. 6-month contract. 100% remote. $80 - $100/hour bill rate. No limit on submittals.

ALTA IT Services is a wholly owned subsidiary of System One, a leading provider of specialized workforce solutions and integrated services. ALTA is an established leader in IT Staffing and Services, for both government and commercial enterprises across the United States, specializing in Program & Project Management, Application Development, Cybersecurity, Data & Advanced Analytics, and Agile Transformation Services.

The Coding Analyst III develops, documents and maintains code level benefit definitions at the Enterprise level for a multi-state and multi-market organization.

Essential Qualifications:

+ Utilize correct coding guidelines to research and interpret complex regulations while collaborating with policy and markets to ensure compliance resolve conflicts i.e. Integrate Essential Health Benefits, Prior Authorization requirements, State Provider agreements, CMS requirements, state-specific regulations, Mental Health Parity, etc., and resolve information source conflicts

+ Create, maintain, review, and analyze configuration templates to validate benefit requirements and regulations are accurate; collaborate with policy and markets to confirm and resolve conflicts

+ Perform peer review of configuration templates and provide documentation of results within the defined SLA guidelines; identify and implement opportunities for improvement

+ Communicate effectively with various internal departments to enhance cross-functional awareness, promote process improvement, and identify root cause resolution of issues

+ Participate in the annual benefit change process with Product Management and Benefit Analysts as appropriate per market

+ Create and utilize reports to analyze data to assist with issue resolution and impact analysis

+ Provide guidance and mentorship to teammates/peers

+ Research and identify industry standard coding practices to stay current and communicate to the BC&S team

+ Adhere to defined SLAs while also accommodating urgent requests

+ Create and maintain SOP’s and supporting process flows

+ Update and maintain the data management tool

+ Attend and support internal/external meetings in conjunction or in place of leadership, as needed

+ Assist in the training and development of new hires and continuous training for department peers

+ Lead and facilitate projects as assigned

+ Assist in Quarterly Code process

+ Act as back up for Team lead in meetings or other functions as appropriate

+ Perform any other job-related instructions as requested

Education and Experience:

+ Bachelor's degree in a related field or equivalent years of relevant work experience is required

+ Minimum of five (5) years of medical coding or medical billing experience required

+ Managed Care experience is required, preferably associated with benefits coding, claims processing, and / or benefit configuration

Competencies, Knowledge and Skills:

+ Advanced computer skills with Microsoft Suite

+ Proven understanding of database relationships preferred

+ Subject Matter Expert level of knowledge in CPT, HCPCS and ICD-CM Codes

+ Working knowledge of other claims related reference data, such as types of bill, revenue codes, places of service

+ Critical listening and thinking skills

+ Proven understanding of the upstream and downstream impacts of code level benefit details

+ Strong problem solving skills

+ Advanced communication skills, both written and verbal

+ Ability to work independently and within a team environment

+ Attention to detail

+ Knowledge of Medicare, Medicaid or Marketplace insurance benefits preferred

+ Claims processing knowledge preferred

+ Ability to work in a fast-paced environment managing multiple priorities

+ Build and maintain strong working relationships with cross-functional teams

+ Strong interpersonal skills and high level of professionalism

+ Facets or other systems knowledge/training preferred

+ Knowledge of regulatory requirements of Outpatient Prospective Payment System (OPPS) and other payer requirements, preferred

+ Excellent organizational skills and ability to meet deadlines

Licensure and Certification :

+ Certified Medical Coder (CPC, RHIT or RHIA) is required

System One, and its subsidiaries including Joulé, ALTA IT Services, and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.

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Ref: #860-IT Cincinnati

System One, and its subsidiaries including Joulé, ALTA IT Services, CM Access, TPGS, and MOUNTAIN, LTD., are leaders in delivering workforce solutions and integrated services across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible full-time employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.