Company Overview:
ZignaAI is focused on delivering innovative solutions that transform healthcare payment operational processes. We empower payers, providers, and patients with AI-powered software solutions that drive transparency in healthcare payment services. Built-in intelligence-enabled machine learning algorithms to deliver pre-billing payment accuracy solutions and avoid provider abrasion. We differ from traditional payment services solutions by resolving issues at the root by ensuring accurate payments, automating processes, with nudges delivered to billing coders. Our innovative and scalable solutions cover Medicaid, Medicare, and Commercial policies and deliver results in weeks.
Opportunity Overview:
This is a great opportunity to get associated with a healthcare analytics company and start as a Medical Coding Analyst and deliver meaningful outcomes that reduce the cost of care. The candidate will work closely with the research team and data team to collect needed details for building intelligence in the system. This will involve good research ability, attention to detail, and constant domain knowledge inputs. This position will require the candidate to be intellectually curious, and with great attention to detail, This role offers the potential to grow at Zigna in research and gain strong domain knowledge. We are committed to developing and nurturing talent at ZignaAI.
Minimum Qualifications:
We are a startup and expect each team member to wear multiple hats, take initiative, and spot and solve problems.
- Bachelor's degree or master's degree, preferably from a life science background
- CPC(AAPC) /CCS(AHIMA) certified
- 1-4 years of experience in medical coding and healthcare.
- Analytical ability to read and analyses medical records and patient details by using the right codes for the billing procedure.
- sound knowledge of medical coding regulations & strong research capabilities
- Ability to apply critical thinking skills to coding policy interpretation and implementation
- Ability to work independently; well-organized and able to set priorities with minimal direction
- Ability to effectively communicate both verbally and in writing
- Strong PC skills; Excel, Word, PowerPoint, and internet-based programs
Responsibilities:
- Creating Edits, logic, and rules related to various coding departments and healthcare topics for finding healthcare fraud and abuse and provider side help them to maximize payment and accuracy.
- Auditing and reviewing medical documentation for appropriate ICD and CPT coding and documentation
- Performing training and education for coding, documentation, and claim payment guidelines, as well as addressing problems and issues
- Reviewing CPT and ICD codes annually for accuracy and implementing changes.
- Helping out physicians and other providers with questions and problems related to coding, documentation, and billing
- Performing extensive research and analysis of appeal data, overpayment, and processes to identify trends and emerging issues, and recommend best practices for maximum performance
- Following appropriate policies, procedures, and guidelines ensuring compliance with state and federal laws, policies, and regulations
- Providing recommendations to leadership to modify reference materials and processes that do not fully satisfy regulatory or legal compliance related to coding
- Initiating follow-up activities to reflect the change for compliance
- Acting as a liaison to other divisions/departments for coding policy and coding issues