Current Career Opportunities
Current Openings
Responsibilities:
- Data mines and analyzes medical coding to aid in identifying overpayments, consistencies, and other trends in claims data.
- Research requests using multiple systems (including: Sales Force, Jira, NPS) to provide all available details to reviewer.
- Use SalesForce, Jira, and NASCO claim systems, to perform functions such as initial claim review, outcome reporting, and distribution based on triage.
- Correspond with providers regarding decisions about requested services and obtain medical records when necessary.
- Review and respond to issues and questions from internal and external customers, both verbally and in writing.
- Work collaboratively with other departments to obtain additional information to resolve inquiries
Qualifications:
- Bachelor’s degree, or equivalent combination of education and experience, with a minimum of 3 years’ experience in medical coding; In-depth knowledge of CPT, ICD-9, ICD-10, HCPCS, DRG diagnosis and procedure coding
- Formal coding certification (eg: CPC, AAPC) is a must
- Experience with both professional and facility claims coding and in APC, HIPPS, or RUG coding and validation
Responsibilities:
- Extract, transform, and load data and translate business requests/requirements into database design
- Work closely with internal and external parties to assist in the testing, implementation, and support of new initiatives
- Design, develop, and implement scalable On-Prem and Cloud solutions
- Utilize your skills in database technologies, data warehousing, and data architecture
Qualifications:
- BS/BA in an IT related discipline or equivalent work experience required.
- 6-10 years of demonstrated software development experience preferably in a healthcare environment
- 6-10 years of experience with several of the following: T-SQL, SSIS, Azure Cloud, PowerShell, Web Services, TFS or other version control tools
- Excellent written and verbal communication skills
- Proven analysis and critical thinking skills
Blue Cross and Blue Shield of Vermont strictly prohibits discrimination against or by any Blue Cross and Blue Shield employee on the basis of race, color, religion, gender, age, national origin, place of birth, sexual orientation, gender identity, ancestry, disability, pregnancy, genetic information or marital status. Blue Cross and Blue Shield will not discriminate against an employee having a positive test result from an HIV related blood test, nor will Blue Cross and Blue Shield request or require an applicant or employee to have an HIV-related test as a condition of employment. Blue Cross and Blue Shield of Vermont will not discriminate against protected veterans.