Medical Policy Analyst
- Salt Lake County, UT
- $28.94-45.91 per hour
- Training
- Full-time
Medical Policy Analyst to join our Medical Policy Team. This pivotal role requires an individual with a
strong background in medical coding and billing, as you will be responsible for analyzing, interpreting,
and overseeing the correct application of reporting standards for medical service coverage.This position is essential for the development of detailed medical program guidance and the
management of core policy functions. The successful candidate will collaborate with internal teams to
ensure our policies are both compliant and effectively implemented.Key Responsibilities:Policy development and revision: Design and revise medical coverage policies in strict
adherence to regulations from the American Medical Association (AMA), the Centers for
Medicare and Medicaid Services (CMS), and relevant state and federal statutes.Compliance analysis: Analyze and review claims to assess compliance with established
Medicaid policies, guidance, and correct coding standards.Expert consultation: Provide expert policy recommendations aligned with current coding
regulations and industry standards.Implementation and coordination: Coordinate with internal stakeholders to ensure the
successful and seamless implementation of new and revised policies.Preferred Qualifications:
- A minimum of four (4) years of experience applying medical coding, billing, or reporting standards.
- Current certification from either the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA).
- AAPC Certifications:
- Certified Professional Coder (CPC),
- Certified Professional Biller (CPB),
- Certified Inpatient Coder (CIC),
- Certified Outpatient Coder (COC), or
- Certified Professional Medical Auditor (CPMA).
- AHIMA Certifications:
- Certified Coding Associate (CCA), or
- Certified Coding Specialist (CCS).
The ideal candidate will possess the following skills and experience:
- Strong technical writing skills for creating clear and precise policy documents.
- Experience with government healthcare programs, particularly Medicaid.
- Proficiency in key coding systems including CPT, HCPCS, ICD-10-CM, and ICD-10-PCS.
- Familiarity with the claims lifecycle, from submission and denial resolution to remittance processes.
- In-depth knowledge of industry-standard tools such as the Integrated Outpatient Code Editor (I/OCE), the National Correct Coding Initiative (NCCI), and Medicare Severity Diagnosis Related Groups (MS-DRG).
- On-site fitness center, for a minimal membership fee
- UTA Eco Pass, at a discounted monthly rate
- Teleworking opportunities with a minimum 2 office days per week beginning 04/2024.
- On-site day care center at the Cannon Health Building with First Steps Day Care - contact for rates and availability, 385-382-4012 or
- Effective July 1, 2021, State of Utah Employees must either reside in Utah or be in the process of relocating to Utah within 30 days of their start date.
- This position may currently be a hybrid of both in-office and remote work days. Please note, a person's eligibility for remote work is establisted by agency management and is subject to change at their discretion, at any time, and for any reason.
- Risks found in the typical office setting, which is adequately lighted, heated and ventilated, e.g., safe use of office equipment, avoiding trips and falls, observing fire regulations, etc.
- Typically, the employee may sit comfortably to perform the work; however, there may be some walking; standing; bending; carrying light items; driving an automobile, etc. Special physical demands are not required to perform the work.
- Please include with your application at least three recent professional references (within the last five years).
The State of Utah offers eligible employees a variety of benefits including medical, dental, life and disability insurance, as well as a comprehensive leave program. Please click the following link for a detailed information page: . To access a Total Compensation Calculator in Excel format click .FMLA General Notice:
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