Coding Operations Support Analyst

This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. For all hires in Minneapolis, Virginia, Maryland, or Washington, D.C. area, you will be required to work in the office for a minimum of four (4) days per week. Opportunities at Northern Light Health , in strategic partnership with Optum. Whether you are looking for a role in a clinical setting or supporting those who provide care, we have opportunities for you to make a difference in the lives of those we serve. As a statewide health care system in Maine, we work to personalize and streamline health care for our communities. If the place for you is at a large medical center, a rural community practice or home care, you will find it here. Join our compassionate culture, enjoy meaningful benefits and discover the meaning behind: Caring. Connecting. Growing together. This position is full time, Monday - Friday. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 8:00 am - 5:00 pm (flexible). It may be necessary, given the business need, to work occasional overtime. We offer 4 - 6 weeks of on-the-job training. The hours of training will be aligned with your schedule.

Professionalism a must with excellent communication skills as this role is client facing Review and resolution of charge inquiries ensuring accuracy and compliance Review and resolution Service Under Review (SUR) and Medical Necessity held accounts to support accurate claims processing and reimbursement Assign and validate ICD-10-CM, CPT, HCPCS, and modifier codes for outpatient surgery, observation, emergency department, ancillary, and professional hospital-based services Analyze and correct coding-related failed medical edits while adhering to official coding guidelines and client-specific requirements Review medical record documentation to ensure coding assignments accurately reflect services rendered Identify coding opportunities, documentation deficiencies, and reimbursement-impacting issues Submit provider queries and provide documentation feedback when clarification is needed Understand and apply Medicare reimbursement methodologies, including APC, OCE, MUE, and NCCI edits Abstract additional clinical and demographic data elements as needed to support coding and reporting requirements Participate in coding education, training, and departmental meetings as needed Track and maintain records of completed, held, and pending accounts Perform additional duties assigned by leadership You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

High School Diploma / GED Active coding credentials through AHIMA OR AAPC (CCS, CIC, CPC, COC, CPC-P, RHIT, RHIA, OR equivalent) Must be 18 years of age OR older 3+ years in acute care hospital, outpatient, OR professional-fee coding environments Knowledge of applicable medical terminology and associated use Understanding of ICD-10-CM, CPT, HCPCS, modifier assignment, and medical necessity guidelines Experience reviewing and resolving coding-related reimbursement issues Proficient with Microsoft business applications Working knowledge of Medicare reimbursement methodologies, including APC, OCE, MUE, and NCCI edits Proficiency with electronic medical records and encoder applications Ability to work full time, Monday - Friday. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 8:00 am - 5:00 pm.

Knowledge of observation services, emergency medicine, surgery, cardiology, interventional radiology, orthopedics, neurology, professional clinic coding Experience with 3M / HDM, Cener, OR similar encoder and EMR systems