Overview
On Site
USD 91,000.00 - 95,000.00 per year
Full Time
Skills
Augmented Reality
Information Assurance
Impact Analysis
Information Architecture
Marketing Operations
SD
Military
Billing
Government Contracts
Business Administration
Finance
Health Information Management
Data Management
Microsoft Office
Process Improvement
Data Visualization
Tableau
Microsoft Power BI
SQL
Microsoft SSRS
Software Requirements Specification
Presentations
Leadership
Quality Improvement
Data Analysis
Decision-making
Reporting
Communication
People Skills
Computer Literacy
Microsoft
Microsoft Outlook
Intranet
Internet
Information Management
Management
FOCUS
Workflow
Organizational Skills
Attention To Detail
Conflict Resolution
Problem Solving
Team Building
Analytical Skill
Accounting
Business Process
Microsoft Excel
Documentation
Research
Project Management
Value Engineering
DoD
Teamwork
Insurance
Health Care
Collaboration
SAP BASIS
Job Details
We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only).
Our Department of Defense contract requires ship and a favorably adjudicated DOD background investigation for this position.
Veterans, Reservists, Guardsmen and military family members are encouraged to apply!
Job Summary
The Coding & Reimbursement Analyst supports claims payment accuracy and waste reduction initiatives by collecting, aggregating, and analyzing claims data from multiple systems. This role requires documenting, reporting, and communicating information, as well as performing claims data analysis to mitigate risks while identifying patterns and trends. The Coding & Reimbursement Analyst has a strong understanding of claims coding and payment methodologies as well as data analytics. This position is responsible for turning claims adjudication and provider billing data into meaningful information, which Claims Admin leadership will use to make informed decisions to improve claims quality, efficiency, and Government contract(s) adherence.
Education & Experience
Required:
Bachelor's degree in Business Administration, Finance, Healthcare, Information Management or equivalent experience
3 years' experience in healthcare analysis, data management or equivalent
3 years' experience in a claims environment, with a strong knowledge of CMS coding and reimbursement methodologies
Proficient in Microsoft Office suite, with an emphasis in Excel and data analysis and reporting
Preferred:
Quality or Process Improvement experience
Experience with data visualization tools such as Tableau, Power BI, etc.
Working knowledge of structured query language (SQL), and SQL Reporting Services (SRS)
Government claims experience
Certified Coding Specialist (CCS) or Certified Professional Coder (CPC)
Key Responsibilities
Acquires claims data from primary or secondary data sources.
Identifies, analyzes, and interprets trends or patterns in complex claims data sets.
Develops visualizations and presentations to summarize and explain claims data findings or quality issues.
Evaluates the completeness and accuracy of claims data.
Works closely with Claims Admin leadership and SMEs on process and quality improvement strategies and/or provider education efforts, resulting from claims data analyses and findings.
Must have strong problem-solving and decision-making skills.
Ability to define problems, collect claims data, establish facts, analyze claims data, and report the findings to appropriate stakeholders.
Ability to collect, aggregate and disseminate data in understandable, digestible, and useful ways across the organization.
Will effectively present claims data information and respond to detailed claims payment or coding questions from varied internal or external groups.
Competencies
Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate.
Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.
Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach.
Information Management: Ability to manage large amounts of complex information easily, communicate it clearly, and draw sound conclusions.
High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.
Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.
Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues.
Team-Building / Team Player: Influence the actions and opinions of others in a positive direction and build group commitment.
Technical Skills: Advanced analytical skills; knowledge of fundamentals of accounting and sound business processes; extensive knowledge of Microsoft Excel; proficient with Word; process diagram and documentation experience preferred; research and project management skills.
Working Conditions
Working Conditions:
Favorable working conditions in a climate controlled office space
May work within an office environment
Company Overview
Taking Care of Our Nation's Heroes.
It's Who We Are. It's What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve !
Our job is to make sure that America's heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.
DoD Statement
Our Department of Defense contract requires ship and a favorably adjudicated DOD background investigation for this position.
Benefits
We're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:
TriWest job postings typically include a salary range, which can vary based on the specific role and location, but generally this position ranges from around $91,000 to $95,000 per year.
Equal Employment Opportunity
TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that supports diversity at every organizational level, and we highly encourage candidates from all backgrounds to apply. Applicants are considered for positions based on merit and without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.
Our Department of Defense contract requires ship and a favorably adjudicated DOD background investigation for this position.
Veterans, Reservists, Guardsmen and military family members are encouraged to apply!
Job Summary
The Coding & Reimbursement Analyst supports claims payment accuracy and waste reduction initiatives by collecting, aggregating, and analyzing claims data from multiple systems. This role requires documenting, reporting, and communicating information, as well as performing claims data analysis to mitigate risks while identifying patterns and trends. The Coding & Reimbursement Analyst has a strong understanding of claims coding and payment methodologies as well as data analytics. This position is responsible for turning claims adjudication and provider billing data into meaningful information, which Claims Admin leadership will use to make informed decisions to improve claims quality, efficiency, and Government contract(s) adherence.
Education & Experience
Required:
Bachelor's degree in Business Administration, Finance, Healthcare, Information Management or equivalent experience
3 years' experience in healthcare analysis, data management or equivalent
3 years' experience in a claims environment, with a strong knowledge of CMS coding and reimbursement methodologies
Proficient in Microsoft Office suite, with an emphasis in Excel and data analysis and reporting
Preferred:
Quality or Process Improvement experience
Experience with data visualization tools such as Tableau, Power BI, etc.
Working knowledge of structured query language (SQL), and SQL Reporting Services (SRS)
Government claims experience
Certified Coding Specialist (CCS) or Certified Professional Coder (CPC)
Key Responsibilities
Acquires claims data from primary or secondary data sources.
Identifies, analyzes, and interprets trends or patterns in complex claims data sets.
Develops visualizations and presentations to summarize and explain claims data findings or quality issues.
Evaluates the completeness and accuracy of claims data.
Works closely with Claims Admin leadership and SMEs on process and quality improvement strategies and/or provider education efforts, resulting from claims data analyses and findings.
Must have strong problem-solving and decision-making skills.
Ability to define problems, collect claims data, establish facts, analyze claims data, and report the findings to appropriate stakeholders.
Ability to collect, aggregate and disseminate data in understandable, digestible, and useful ways across the organization.
Will effectively present claims data information and respond to detailed claims payment or coding questions from varied internal or external groups.
Competencies
Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate.
Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.
Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach.
Information Management: Ability to manage large amounts of complex information easily, communicate it clearly, and draw sound conclusions.
High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.
Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.
Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues.
Team-Building / Team Player: Influence the actions and opinions of others in a positive direction and build group commitment.
Technical Skills: Advanced analytical skills; knowledge of fundamentals of accounting and sound business processes; extensive knowledge of Microsoft Excel; proficient with Word; process diagram and documentation experience preferred; research and project management skills.
Working Conditions
Working Conditions:
Favorable working conditions in a climate controlled office space
May work within an office environment
Company Overview
Taking Care of Our Nation's Heroes.
It's Who We Are. It's What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve !
Our job is to make sure that America's heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.
DoD Statement
Our Department of Defense contract requires ship and a favorably adjudicated DOD background investigation for this position.
Benefits
We're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:
- Medical, Dental and Vision Coverage
- Generous paid time off
- 401(k) Retirement Savings Plan (with matching)
- Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
- Tuition reimbursement
- Paid volunteer time
TriWest job postings typically include a salary range, which can vary based on the specific role and location, but generally this position ranges from around $91,000 to $95,000 per year.
Equal Employment Opportunity
TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that supports diversity at every organizational level, and we highly encourage candidates from all backgrounds to apply. Applicants are considered for positions based on merit and without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.