Coding Specialist (req105) Minneapolis, Minnesota

About UCare
    
At UCare, we deliver high-quality health coverage and services to help more than 400,000 members of all ages maintain and improve their health. It's a big job that takes innovative ideas, strategic partnerships, and a commitment to doing the right thing. Above all, it takes a compassionate team that is dedicated to making a real difference in the lives of our members and our communities.
 
Working at UCare is more than just a career; it's a mission. A mission that defines us as professionals, unites us as an organization, and shapes how we interact with our members and each other.
 
Coding Specialist
The Coding Specialist is responsible to identify and analyze all changes (additions, deletions, modifications) to CPT, HCPCS and ICD-9-CM codes and facilitate the timely implementation of same across all appropriate departments and business systems. Collaborate with Configuration staff to enhance operational effectiveness and efficiency by identifying opportunities for automation of existing manual claims processes. Serve as a subject matter expert for Member Services, Provider Assistance Center, Provider Relations and other appropriate departments and provide information and education on coding and coding-related issues. Facilitate the development of education materials for key areas and identify training opportunities for internal and external customers.  Research and resolution of complex claim and reimbursement issues.
 
DUTIES AND RESPONSIBILITIES:
  • Oversee and maintain process for implementation of quarterly, annual and bi-annual updates to CPT, HCPCS and ICD-9-CM codes.
  • Identify and analyze coding changes as they relate to accurate claims processing.
  • Facilitate timely implementation of all coding changes. Minimize rework by ensuring all stakeholders are aware of and understand coding changes and the impact the changes have on individual lines of business.
  • Develop education /training materials for key internal business areas related to governmental coding and reimbursement issues. Assist in the identification of how coding changes will impact specific departments or areas. 
    Education and training for operational areas on fundamental coding information.
  • Serve as a primary resource for coding and reimbursement issues.
  • Assist in the development of training and education materials for providers. Present focused education for providers as needed to minimize claim denials and unnecessary rework.
  • Represent UCare at external professional committees, including Administrative Uniformity Committee technical advisory groups, HCPCS and HECAP.  Proactively distribute information as appropriate across departments.
  • Collaborate with Medical Directors, clinical staff, Provider Relations, Member Services, Provider Assistance Center and other identified areas/departments in the management and resolution of complex claim issues, alignment of medical policy with coding and reimbursement criteria and other related issues.
  • Collaborate with Configuration staff to identify opportunities to maximize operational effectiveness and efficiency by reducing unnecessary rework, increasing automation and improving auto-adjudication rates.
Current and valid certification as a professional coder from an accredited institution. Three years of experience as a certified coder in a healthcare delivery setting, health insurance (payer) setting or Medicare and/or Medicaid setting is required. Microsoft Word, Excel and PowerPoint skills strongly preferred.

The UCare Difference
 
UCare is proud to be a recognized Star Tribune Top Workplace for the 5th consecutive year. As a part of our collaborative team, you'll experience the rewards that come with helping others and seeing the positive results of your hard work. We value and respect each individual's ideas and contributions, and give you the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, a myriad of volunteer activities, and a number of other rewards.
 
If you're looking for a welcoming environment that celebrates what you have to offer, helps you build on your strengths, and gives you the opportunity to truly make a difference, we invite you to apply.
 
As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

 

To apply, please click here