Benefit Design and Coding Informaticist

Posting Date: 01/14/2019
Closing Date: 03/29/2019
Posting Level: Mid-Level

Bind is a health technology and services company founded in 2016 and headquartered in Minneapolis, MN with satellite offices in New York and San Francisco. Bind is health insurance for the way we live now. Unlike traditional health insurance that charges you for services you may never need or want, Bind is on demand: pay for what you need, not what you don’t, and adjust your coverage when those needs change. Health coverage that’s flexible, clear, and intuitive.

We are creative, collaborative, and a little bit fiery. The Bind team is comprised of like-minded individuals passionate about healthcare, and our cause is the collective act of rewiring it. We embrace new ideas. We’re more wheel than cog. More spark than smoke. And we are playful and venturesome in our daily mission to render real and refreshing solutions to health insurance that works better for us all.

Benefit Design & Coding Informaticist

Summary
Our newly created Benefit Design & Coding Informaticist will be an experienced benefit design and coding informaticist. You will play a key role in enabling the Bind benefit plan by reviewing and analyzing the benefit plan and partnering with Clinical, Financial and Operational subject matter experts to ensure use and adoption of appropriate coding standards through the development, implementation and administration of the Bind benefit.

Responsibilities
• Lead development and maintenance of code sets across Bind capabilities.
• Assist in enabling the Bind benefit plans by reviewing and analyzing intent, coding and configuration.
• Review Bind benefit plan for accuracy and completeness of codes, ensuring all codes are current and active. Conduct regular review of benefit plan codes to maintain compliance with standards.
• Ensure compliance with member benefit regulations across Bind plan designs (Essential Health Benefits, Mental Health Parity, etc.).
• Create and maintain coverage specifications for Bind plan designs. Partner with Plan Design, Clinical and Operations to develop and maintain program/solution documentation and specifications.
• Create and maintain lists of codes applicable to medical, payment and benefit design policies to enable reliable representation of benefits and to power adjudication.
• Provide subject matter expertise for claim processing, ensuring appropriate interpretation and application of medical coding standards in setup and configuration of claim adjudication engine. Ensure all appropriate codes are assigned and sequenced as needed.
• Serve as a resource regarding coding questions and interpretation of standards; provide leadership on use of codes and changes to coding standards as needed.
• Assist in translation of consumer-friendly medical terms and concepts into the proper clinical codes.
• Ensure adherence to state and federal compliance policies, reimbursement policies and contract requirements.
• Facilitate meetings with Account Partners, Clinical, Operations and others to achieve benefit design solutions that meet needs and expectations.

Requirements
• Bachelor's degree or equivalent years of relevant work experience.
• 5 years business/operations experience in a health plan environment and familiarity with commercial plan design.
• 5 years of medical benefit plan design and/or configuration and medical coding experience.
• Medical Coding Certificate; RHIT or CPC by AAPC or AHIMA license or working knowledge of coding within benefit and claim adjudication.
• Working knowledge of HCPCS, CPT, ICD10 CM and PCS, J codes and Rev codes.
• Strong preference for familiarity with SNOMED and LOINC, NDC.
• Experience in the application of medical and reimbursement policies within the claims adjudication process.
• Experience performing coverage review which requires interpretation of state and federal mandates, applicable benefit language, medical and reimbursement policies, coding requirements and consideration of relevant clinical information on claims.
• Experience assisting in the plan build/plan configuration of claim adjudication platform.
• Strong analytical skills.
• Clear, concise, engaging and effective written and oral communication.
• Willingness and ability to be both an individual contributor and a team player.
• Ability to influence without direct control.
• Proficient in Microsoft Word, Excel, PowerPoint, etc.
• Accurate and precise attention to detail.

Bind is committed to providing equal employment opportunities. All qualified applicants and employees will be considered for employment and advancement without regard to race, color, religion, national origin, sex, disability, age, marital status, sexual orientation, veteran status, genetic information, or any other status protected by applicable law.



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