Claims Resolution Coder
Sentara Health
full-time
Posted on:
Location Type: Remote
Location: Remote • Virginia • 🇺🇸 United States
Visit company websiteSalary
💰 $22 - $37 per hour
Job Level
JuniorMid-Level
About the role
- Responsible for reviewing medical documentation to assign modifiers to insurance claims with issues identified by the National Correct Coding Initiative (NCCI), Medicare Outpatient Code Editor (OCE), or other third party payer specific claims processing guidelines
- Works with Coding, Billing and Reimbursement staff to resolve edits
- Responsible for trending errors, supporting identification of root causes, and effective communication with coding and training staff to improve coding accuracy and clean claims processing
- Researches regulations to ensure accuracy of CPT codes and documentation.
Requirements
- Associates degree in Health Information Technology or Medical Billing preferred
- 2 years direct application of coding, medical billing or reimbursement in health care setting, hospital or physician office required
- CPC or CCS coding certification required at time of hire
- Thorough knowledge of lab, radiology and other ancillary, CPT, HCPCS related modifier and revenue codes, as well as knowledge of Medicare NOD and LCD guidelines
- Demonstrates working knowledge of medical record documentation requirements and ability to interpret documentation.
Benefits
- Medical, Dental, Vision plans
- Adoption, Fertility and Surrogacy Reimbursement up to $10,000
- Paid Time Off and Sick Leave
- Paid Parental & Family Caregiver Leave
- Emergency Backup Care
- Long-Term, Short-Term Disability, and Critical Illness plans
- Life Insurance
- 401k/403B with Employer Match
- Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
- Student Debt Pay Down – $10,000
- Reimbursement for certifications and free access to complete CEUs and professional development
- Pet Insurance
- Legal Resources Plan
- Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
medical codingmedical billingreimbursementCPT codingHCPCS codingmodifier assignmentclaims processingerror trendingroot cause analysisdocumentation interpretation
Soft skills
effective communicationcollaborationproblem-solvingattention to detail
Certifications
CPCCCS