Job Description

• M1 Two (2) years of experience as a data analyst or in other quantitative analysis or engineering disciplines, such as researcher, data engineer or BI analyst. PASS/FAIL
• M2 Possess a bachelor’s degree. Additional qualifying experience may be substituted for the required education on a year-for-year basis. PASS/FAIL
• M3 Three (3) years of FTE experience working with ICD-9, ICD-10, Current Procedure Terminology (CPT), and Health Care Procedure Coding Standardization/Systems (HCPCS) Level II coding standards. PASS/FAIL
• M4 Two (2) years of FTE experience working with Centers for Medicare and Medicaid Services (CMS) 1500 and Universal Billing (UB) UB-04 claim forms and billing requirements. PASS/FAIL
• M5 One (1) year of FTE experience working with Accredited Standards Committee (ASC) X12N 837 electronic claim billing
• One (1) year of FTE experience working with Standard Setting organizations, like: American Medical Association (AMA), National Uniform Claims Committee (NUCC), National Uniform Billing Committee (NUBC), Centers for Medicare and Medicaid Services (CMS), Health Level 7 (HL7), American Psychiatric Association (APA), and National Council for Prescription Drug Programs (NCPDP). PASS/FAIL 
• M7 Three (3) years of FTE experience working with Medicaid, Medicare, and third-party payer requirements. PASS/FAIL 
• M8 One (1) year of FTE experience working with HIPAA regulations. PASS/FAIL 
• M9 Two (2) years of FTE experience of medical coding experience in a hospital, clinic, outpatient setting, or health insurance carrier environment. PASS/FAIL 
• M10 Be certified by the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) as an ICD-10 certified coder or instructor / trainer, and have current certification in at least one of the following categories: Certified Coding Specialist (CCS)
• Certified Coding Specialist Physician (CCS-P) 
• Certified Procedural Coder (CPC)


DESIRABLE QUALIFICATIONS: (D)

• Experience with Medi-Cal billing policies and requirements. 
• Five (5) points will be given for every twelve (12) months of experience for a maximum of ten (10) points. 
• 10 D2 Experience with the Medi-Cal Procedure Master File. 
• Five (5) points will be given for every twelve (12) months of experience for a maximum of ten (10) points. 
• 10 D3 Experience working with Optum Encoder Pro, MS Word, and MS Excel. 
• Five (5) points will be given for every twelve (12) months of experience for a maximum of ten (10) points. 
• 10 D4 Experience in state policy and regulation formation. 
• Five (5) points will be given for every twelve (12) months of experience for a maximum of ten 
• Bachelor of Arts/Bachelor of Science in a health-related field. 
• Ten (10) points will be given a Bachelor of Arts/Bachelor of Science in a health-related field. 
• 10 D6 Experience performing ICD-10 analysis. 
• Five (5) points will be given for every twelve (12) months of experience for a maximum of ten (10) points.
About Estrada Consulting Incorporated:



Estrada Consulting, Inc. (ECI) delivers technology-enabled services and solutions to clients all over the USA and British Columbia. We provide system integration, custom application development, data warehouse and business intelligence, project management, custom reporting solutions and consulting services to mid-size and large enterprises in all major industries. The Company headquarters is in Sacramento, California, and was established in year 2000. Visit to learn about our projects, managed services, awards and certifications delivering value for a range of businesses and government agencies.

Job Tags

Similar Jobs