Senior Analyst - Medical Coding

With more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust.

Detroit, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="https://www.bcbsm.com/" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.&nbsp;<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="http://www.bcbsm.com/index/about-us/our-company.html" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />For Application Timeline &amp; Selection Process:&nbsp;<a href="https://s3.amazonaws.com/data.vizirecruiter.com/Images/BCBSMCareers+-+Quick+Reference+Guide.pdf" target="_blank" rel="noopener noreferrer">Click Here</a>. Learn more about your options as an external candidate. <a href="https://ejko.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_3/requisitions" target="_blank" title="BCBSM" rel="noopener noreferrer">Click here</a> to view open positions. http://www.bcbsm.com

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Full-Time

Competitive Total Compensation Package

Overview: Responsible for leading the development and implementation of programs and strategies by identifying insights that enhance business decision-making capability. This includes developing or changing workflows and implementing process improvements to enhance organizational products, programs, and services to our customers.
Responsibilities: <ul> <li>Identify and analyze operational data and develop insights in support of business objectives.</li> <li>Develop and improve workflows and business processes within defined areas to improve customer service, decrease operational costs and improve overall quality.</li> <li>Identify and/or analyze business problems and develop recommendations for solutions to problems.</li> <li>Lead the development and implementation of projects and/or teams in order to produce desired results.</li> <li>Document and communicate project concepts, milestones and results.</li> <li>Recommend and assist with implementing standard policies and procedures.</li> <li>Ensure that corporate compliance is communicated, implemented, and monitored on an ongoing basis.</li> <li>Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.</li> <li>Provide support to internal departments and external entities by answering questions, supplying information and training.</li> <li>Create and present reports and presentations to display operational data and proposed business changes.</li> </ul>
Requirements: <ul> <li>Bachelor's Degree in a related field is preferred.</li> <li>Four (4) years of experience in a related field is required.</li> <li>Excellent analytical and problem-solving skills to identify, evaluate, recommend and implement changes to processes or procedures to address problems and improve departmental effectiveness.</li> <li>Organizational skills and ability to prioritize; must be able to lead multiple activities with varying timelines.</li> <li>Excellent verbal, written communication, and interpersonal skills.</li> <li>Ability to lead and contribute to business unit and/or corporate projects.</li> <li>Proficient in Microsoft Office Suites.</li> <li>Ability to develop and maintain effective working relationships.</li> </ul> <br /> <p>Departmental Requirements:</p> Knowledge and experience of the following:<br /> <ul> <li>ICD-10-CM and PCS Codes</li> <li>Monitor and review IPPS proposed/final rule for any ICD-10-CM/PCS coding changes</li> <li>CPT and HCPCS codes</li> <li>Identify Super PHI indications</li> <li>Inpatient Prospective Payment System (IPPS)</li> </ul> Responsibilities Includes:&nbsp;<br /> <ul> <li>Composing and release PCRs and CRs for new ICD-10-CM/PCS codes.</li> <li>Research new or existing drug indications and provide</li> <li>corresponding ICD-10-CM codes.</li> <li>Respond to coding related inquiries &nbsp;</li> <li>Provide the medical consultants with through research information of coding guidelines</li> </ul>