Utilization Management Data and Coding Specialist

We have an opportunity to join the Alliance as a Utilization Management Data and Coding Specialist in the Utilization Management Department.

Reporting to the Utilization Management Manager - Authorizations and Transportation, this position:

• Performs routine data analysis, research, reporting, and project assistance in support of Utilization Management Department programs
• Performs monitoring and maintenance of the departmental coding system to ensure data integrity and acts as the Utilization Management Department medical coding subject matter expert

THE IDEAL CANDIDATE

• Current Certified Professional Coder (CPC) issued by the American Academy of Professional Coders OR current Certified Coding Specialist - Physician Based (CCS-P) issued by the American Health Information Management Association
• Some experience with data analysis or supporting program data in a healthcare setting
• Demonstrated experience taking initiative, being resourceful to figure things out and has an aptitude to learn and incorporate new things as they come up

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here

• Knowledge of:
• The principles and practices of medical coding and methodologies
• The principles and practices of internal data auditing
• Research, analysis, and reporting methods
• Medical terminology including procedures and diagnoses coding
• Working knowledge of the healthcare industry
• Ability to:
  • Learn and utilize Alliance information systems
  • Enter, proofread, verify, analyze, and audit data
  • Review data to ensure data integrity and quality and to identify data anomalies
  • Produce organized, accurate, and detail-oriented work and maintain accurate records
  • Act as a technical resource and explain policies, regulations, terms, and procedures related to area of responsibility
• Education and Experience:
  • Current Certified Professional Coder (CPC) issued by the American Academy of Professional Coders or current Certified Coding Specialist - Physician Based (CCS-P) issued by the American Health Information Management Association
  • Bachelor's degree in Healthcare, Business or a related field
  • A minimum of three years of experience performing data analysis or related program support in a healthcare environment, which included some medical coding experience (a Master's degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying

OTHER INFORMATION

• We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.

The full compensation range for this position is listed below.

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).

Typical areas in Zone 1: Bay Area, Sacramento, Los Angeles area, San Diego area

Typical areas in Zone 2: Fresno area, Central Valley (with the exception of Sacramento), Eastern California, Eureka area