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Benefits Coding Analyst I

Company: Kaiser Permanente
Location: Burbank
Posted on: May 12, 2022

Job Description:

Responsible for translating benefit policies to ensure that policies are designed and configured appropriately in KP system in order to ensure that assignment to industry standard codes (CPT, HCPCs, ICD-10) thus enabling appropriate billing and claims adjudication and receipt of accurate member cost-share at point of service. Review benefit policies as written by Benefit Policy to ensure that new benefits policies have appropriate industry standard codes assigned to each covered benefit. Also responsible for on-going code maintenance, e.g., quarterly and annual code updates. Accountable for resolving coding-related production issues and resolution of benefit testing gaps.Essential Functions:

  • Translates less complex new benefit policies to ensure that associated benefits are designed and configured appropriately in KP systems to ensure accurate assignment to industry standard codes that will facilitate appropriate billing and claims adjudication and receipt of accurate member cost-share at point of service.
  • Partners with Benefits Systems Management (BSM) to resolve testing gaps during implementation.
  • Code Updates: Ensure quarterly and annual CPT, HCPC, and ICD-10 codes are updated.
  • Responds to and resolves in a timely manner production issues related to coding issues.

    Basic Qualifications:Experience
    • Minimum two (2) years of experience in revenue cycle, pricing, or charge description/fee schedule development or claims billing experience.Education
      • Bachelor's degree, OR four (4) years of experience in a directly related field.
      • High School Diploma or General Education Development (GED) required.License, Certification, Registration
        • N/A
          Additional Requirements:
          • Must be able to work in a Labor/Management Partnership environment.Preferred Qualifications:
            • Previous experience working in a managed care environment.
            • Experience resolving billing and claims issues related to benefit code assignment preferred.
              PrimaryLocation : California,Burbank,Marketing, Sales, Service and Admin
              HoursPerWeek : 40
              Shift : Day
              Workdays : Mon, Tue, Wed, Thu, Fri
              WorkingHoursStart : 08:00 AM
              WorkingHoursEnd : 05:00 PM
              Job Schedule : Full-time
              Job Type : Standard
              Employee Status : Regular
              Employee Group/Union Affiliation : NUE-PO-01-NUE-Non Union Employee
              Job Level : Individual Contributor
              Job Category : Insurance & Claims
              Department : MSSA Admin Offices - HP Func-Benefits System Mgmt - 7016
              Travel : Yes, 15 % of the Time
              Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

Keywords: Kaiser Permanente, Burbank , Benefits Coding Analyst I, Professions , Burbank, California

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