Clinical Coding Intelligence Specialist
1 month ago
Bupa is seeking a highly skilled Clinical Coding Intelligence Analyst to join our team. As a key member of our Healthcare Insights team, you will play a pivotal role in improving our understanding of healthcare data through a clinical coding lens.
Key Responsibilities:- Data Analysis: Utilize clinical coding intelligence to analyze large datasets, identifying trends, patterns, and anomalies related to healthcare costs, case-mix, utilization, and outcomes.
- Insights and Recommendations: Support the Healthcare Insights team in presenting complex data in a clear and actionable manner, translating data findings into strategic recommendations for stakeholders.
- Clinical Tools and Enablers: Embed robust clinical coding intelligence into our clinical tools, supporting ongoing HCM strategies.
- Clinical Coding Crosswalks: Develop a suite of clinical coding crosswalks, facilitating the translation of codes between different classification systems.
- DRG Grouper Governance: Lead strategy development and implementation of ongoing management of Diagnosis Related Grouper (DRG) versions and application to Bupa's funding models and claims system integration.
- Industry Engagement and Representation: Represent Bupa in industry-related engagements and working groups regarding clinical classification tools and DRG Grouper development.
- Communication and Collaboration: Present findings and recommendations to senior management and other key stakeholders, working closely with IT and data management teams to ensure data integrity and system compatibility.
- Tertiary qualifications in Clinical Coding or Healthcare Information Management and/or Health Science field beneficial.
- Certified Professional Coder (CPC) or Coding Specialist (CCS)
- Minimum of 3-5 years of experience in clinical coding, data analysis, with a strong understanding of coding systems in Australia (ICD-10, ACHI, and ACS) and coding in other global healthcare markets.
- Significant knowledge of healthcare data, clinical coding, case-mix principles, risk adjustment, and the ability to build financial and benchmarking models.
- Proficiency in data analysis tools and software (e.g., SQL, SAS, Tableau, Excel, R, and Python)
- Understanding of the Australian healthcare system and its ongoing reform.
- Experience with private healthcare sector and regulatory requirements.
- Proven capacity to communicate complex data insights clearly to technical and non-technical audiences.
- Proven capacity to work well independently and collaborate with others, as required.
- Excellent analytical, problem-solving, and critical-thinking skills.
- Strong attention to detail and commitment to data accuracy.
- Exceptional written and presentation skills, with the ability to convert data into insight and prepare compelling, persuasive reports and presentations suitable for executive and board-level content.
- Excellent time management skills.
- A track record of achievement and delivery.
As a Clinical Coding Intelligence Analyst at Bupa, you will be challenged and encouraged to innovate, collaborating with colleagues who are committed to delivering exceptional experiences. You will enjoy a range of Bupa benefits, flexible working, and the opportunity to make a meaningful impact in the healthcare industry.
- Discount on our health insurance, travel, car, home, contents, and pet insurance products, as well as Bupa services such as Dental and Optical.
- A 'People First' wellness program – SMILE – providing a range of services, including health coaches, annual skin checks, flu vaccinations, assistance with nutrition, mental and general well-being guides, and product discounts.
Bupa is committed to creating and sustaining a safe and inclusive workplace. We welcome applicants from all cultural backgrounds, genders, and abilities. If you require any adjustments to participate in our recruitment process, please let us know at the time of your application.
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