Associate-Claims Coding Senior - Indianapolis - Full Time Day

Manages and coordinates the application of medical claims billing codes. Identifies and monitors accurate coding practices based on CMS, state and federal guidelines. Monitors authorization and service category for coding changes and accuracy. Monitors authorization approval rates and claims auto adjudication. Owns and oversees the review of accurate codes submitted on medical claims including; ICD-10, CPT, HCPCS. Collaborates with internal departments and external vendors to ensure the appropriate usage of codes, conducts high dollar, coverage determinations and reimbursement claims audits. Owns clinical editing appeals resolution and system(s) assessment of annual code and compliance updates. Communicates with internal and external customers regarding coding deficiencies and updates to achieve accurate claims adjudication based on compliant use and submission of valid medical billing codes.

• Bachelor's Degree preferred.
• RHIT, CMC, CRC, CCS, CCS-P, CPC-P or CPC-H preferred.
• 2-4 years of experience required.
• Experience in all areas of outpatient/hospital coding through literature reviews and attendance at workshops/in-services is required.
• Working knowledge of governmental annual code updates and determinations required.
• Health Plan and Claims knowledge preferred.
• Knowledge of NCQA, CMS, ACA, IDOI & AAPC coding guidelines preferred.
• Knowledge in the interpretation of clinical data to accepted coding guidelines preferred.
• Experience in trending coding patterns and conducting regular monitoring and assessment of coding assignment decisions to ensure appropriateness of reimbursement preferred.
• Working knowledge of ICD-10-CM; CPT; DRG, APC, with expertise in ICD-10-CM coding principles and reimbursement implications as well as modifier rules preferred.
• Working knowledge of overseeing complex audits and ability to troubleshoot, using electronic medical records, audit issues with providers and internal departments preferred.

• Indiana University Health has nearly 40,000 team members, including more than 3,600 physicians and 1,200 advanced practice providers, and we’re home to the largest nursing network in Indiana with more than 9,000 nursing team members at over 800 sites of care.
• IU Health is ranked No. 1 in Indiana by U.S. News & World Report, Riley Children's Health is ranked among the top children's hospitals in the country by U.S. News & World Report.
• A unique partnership with the Indiana University School of Medicine – one of the nation’s largest medical schools – gives patients access to groundbreaking research and innovative treatments, and it offers team members access to the latest science and the very best training – advancing healthcare for all.
• With 15 hospitals, including seven with Magnet designation and eight with Pathways to Excellence designation, our team members are leading the way through excellence.
• At Indiana University Health, your personal and professional growth is a top priority. You will have access to many diverse opportunities to learn and develop in meaningful ways that matter most to you, such as advanced clinical training, leadership development, promotion opportunities and cross training development.
• Indiana University Health is invested in the lives of Hoosiers, leading the transformation of healthcare to make Indiana one of the nation’s healthiest states.