Aetna Certified Coding Specialist Team Lead in Hartford, Connecticut

Req ID: 42653BR

POSITION SUMMARY

Position is for Clinical Coding Supervisor/ Team Lead who will be responsible for managing team of certified coders. Candidate must also be a certified professional coder and will be expected to also perform clinical coding reviews as necessary.

Fundamental Components:

Certified clinical coder supervisor needed to support clinical and medical policy reviews and implementation. Candidate may also be called upon to perform audits of medical and/or hospital records to validate that proper coding guidelines have been followed. Supervisor will manage coding and implementation of Clinical Policy Bulletins (CPBs). This includes research of coding standards across the industry and code sources. Associate must be familiar with claim editing software as they need to be able to propose system changes and/or new edits associated with their CPB code findings. Supervisor will be responsible for managing the DRG coding reviews and may be asked to review medical and/or hospital records to provide clinical coding advice on DRG claims. Individual will use clinical coding resources to ensure accurate coding of DRG inpatient claims. Supervisor will manage various coding project as assigned including creating and maintaining condition categories for critical care benefit programs. Supervisor will be responsible for coordinating coding research projects, advise on clinical coding and implementation of state mandates. Individuals will be required to complete and track system submissions to update the various claim systems. They will also respond to inquiries from Compliance with regard to audits related to the above referenced topics.

BACKGROUND/EXPERIENCE desired:

Proven track record in meeting project milestones and negotiating for resources; 1-3 years of clinical coding experience in the health care industry; Current coding certification from recognized national organizations; Extensive experience in performing reviews of clinical records to confirm recognized industry coding standards have been followed; Excellent verbal and written communication skills;

EDUCATION

The minimum level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.

FUNCTIONAL EXPERIENCES

Functional - Clinical / Medical/Clinical claim review & coding/1-3 Years

Functional - Claims/Policies & procedures/1-3 Years

Functional - Communications/Communication Delivery - Public Speaking/1-3 Years

TECHNOLOGY EXPERIENCES

Technical - Operating Systems/Windows 2000/4-6 Years/Power User

REQUIRED SKILLS

Communicating for Impact

Consulting for Solutions

Engaging and Developing People

DESIRED SKILLS

Driving Change

Creating Accountability

ADDITIONAL JOB INFORMATION

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Job Function: Management