• Change Healthcare
  • Duluth , MN
  • Non-Executive Management
  • Full-Time

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Transforming the future of healthcare isn t something we take lightly. It takes teams of the best and the brightest, working together to make an impact.

As one of the largest healthcare technology companies in the U.S., we are a catalyst to accelerate the journey toward improved lives and healthier communities.

Here at Change Healthcare, we re using our influence to drive positive changes across the industry, and we want motivated and passionate people like you to help us continue to bring new and innovative ideas to life.

If you re ready to embrace your passion and do what you love with a company that s committed to supporting your future, then you belong at Change Healthcare.

Pursue purpose. Champion innovation. Earn trust. Be agile. Include all.

Empower Your Future. Make a Difference.

Directs operations activities for the Coding Review team made up of certified medical coders and RNs, this includes pre and post-pay coding reviews, new employee training, client deliverables, client support, and creating and maintaining documentation and templates for consistent and accurate reviews.

Education / Training:

  • AS degree or Equivalent in Health Information Management required
  • Nationally recognized coding credential required: RHIA, RHIT, CCS-P, or CPC, CPC-H
  • RN with Bachelors Degree preferred.
  • Business Experience:

  • 3-5 years operations management to include coaching and proven track record of successful management and development of staff.
  • 4+ years experience in coding or an equivalent combination of education and experience
  • 4 + years of physician and hospital medical claims experience
  • Proven ability to review, analyze, and research coding issues
  • Reimbursement policy and/ or claims software analyst experience
  • Proven record to achieve results in a production/quality driven environment.
  • Specialized Knowledge / Skills:

  • Knowledge of healthcare payment integrity a plus
  • Knowledge of claims editing software and rules development a plus
  • Excellent communication skills both verbal and written
  • Good interpersonal skills
  • Able to establish good customer relationships with trust and respect
  • Computer skills: navigation and edit resolution through various Web based systems, ability to use email, Excel, Word.
  • Self-motivated professional, with strong influencing and negotiation skills
  • Attention to detail
  • Ability to manage multiple priorities
  • Demonstrate ability to collaborate and able to develop and maintain effective relationships with individuals at various levels of the organization
  • Strong people assessment and performance development skills
  • Ability to perform coaching and development of staff
  • Job Responsibilities

  • Manages the coding review team (10-15 team members) to ensure deadlines are met and workload is effectively balanced
  • Serves as a CPT/HCPCS coding resource and provides coding expertise and guidance to entire record review, clinical and/or coding teams
  • Analyzes medical documents to evaluate potential areas of fraud, waste, errors and abuse
  • Coordinate activities with varying levels of leadership, record review team, internal and external customers and medical professionals through effective verbal and written communications
  • Monitors CMS and major payer coding and reimbursement policies
  • Researches and interprets correct coding guidelines and internal business rules to respond to customer inquiries
  • Provides complete, accurate and timely responses to internal departments (including client data support, sales, account management, project management, record review, IT), as well as external clients
  • Ensures projects are completed within committed time and budget and are integrated with other business and related projects
  • Provides measurement and cost savings support (development, reporting, validation and improvement) for service management
  • Ensures team has tools and resources necessary for completing work effectively and accurately including creating and maintaining templates and documentation for reviews
  • Participates in process improvement activities and encourages ownership of and group participation in improvement initiatives
  • Identifies and recommends opportunities for cost savings and improving outcomes
  • Provides support for personnel related items including hiring, assisting in development of staff and working through any performance improvement processes
  • Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!

    Equal Opportunity/Affirmative Action Commitment

    All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

    * The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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