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Posted: Wednesday, February 7, 2018 10:06 PM

Who we are:
Meridian Health Plan is a family-owned, family-operated company of passionate leaders, achievers, and innovators dedicated to making a difference in the lives of our members, our providers and in the healthcare industry.
We provide government-based health plans (Medicare, Medicaid, and the Health Insurance Marketplace) in five different states (Michigan, Illinois, Indiana, Kentucky, and Ohio).
Our employees work hard, play hard, and give back. Meridian employees enjoy: Happy hours, special events, company sports teams, potlucks, Bagel Fridays, weekly Executive Lunches, and volunteer opportunities.
A Day in the Life of a Claims Coding Specialist:
This positionmust accurately analyze and code Medicare insurance claims in accordance with nationally recognized coding guidelines through evaluation of medical records. Properly assign appropriate clinical diagnosis and procedure codes. Act as a coding resource to other staff.
+ Analyzes medical information from medical records. Accurately codes diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate assignments of ICD9 and/or CPT4 codes, MS-DRGs, APCs, POAs and reconciliation of charges
+ Audits documentation to verify coding accuracy and to identify missing information
+ Assure compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standard
+ Researches insurance questions about codes and charges
+ Provides information to providers regarding billing, account status and payment inquiries
+ Research and resolution of coding projects as assigned
+ Research and implement revisions to Rules and Regulations which govern inpatient & outpatient physician coding
+ Attend seminars related to Coding and Compliance and education of new Payment Systems
+ Serve as a coding resource for internal departments
+ Attend meetings as necessary to provide information relating to coding and compliance
+ Inform Management of trends identified through the review and validation process
+ Provide related weekly, monthly and year end reports of audit findings
+ Serve as a liaison with external auditors for corporate audits
+ Facilitate physician education and coordinate coder education
What you can bring to Meridian:
+ High School Diploma is required
+ Bachelor s Degree or Fellow Designation from the Academy of Healthcare Management (AHM) is preferred
+ One of the following certifications: Registered Health Information Administrator (RHIA) Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) in an active status with American Health Information Management Association or American Academy of Professional Coders. Will consider experience in lieu of certification/degree. CCS required within 6 months of employment
+ 2-3 years of experience in a medical office setting or similar environment
+ Demonstrated successful completion of medical terminology course
+ Previous medical claims coding, auditing, billing or payment experience required
+ Thorough knowledge of CPT4, ICDCM, HCPCS, Medicare, Medicaid, and insurance guidelines
+ Knowledge of healthcare claims reimbursement methods and rates
+ Personal computer skills and software packages including Microsoft Office, Excel and Word, and mail merge capabilities
+ Strong organizational, planning, analytical and communication skills
+ Excellent analytical and problem solving skills
What Meridian can offer you:
+ Our healthcare benefits include a variety of PPO plans that are effective on the first day of employment for our new full-time team members.
+ Opportunity to work with theindustry s leading technologiesand participate in unique projects, demonstrations, conferences, and exclusive learning opportunities.
+ Meridian offers401k matchingthat is above the national average.
+ Full-time MHP employees are eligible for tuition reimbursementtowards Bachelor s or Master s degrees.
+ Meridian Health Plan was named Detroit's #1 Fastest Growing Company by Crain's Magazine, so it is a great time to get involved with Meridian.
Equal Opportunity Employer
Job ID2018-5077
Business LineCMC Corporate
Associated topics: automobile, casualty, claim, claimant, damage, fraud, insurance adjuster, insurance examiner, investigate, investigation


• Location: Detroit

• Post ID: 46439212 detroit is an interactive computer service that enables access by multiple users and should not be treated as the publisher or speaker of any information provided by another information content provider. © 2018