Claims Resolution Coder/CPC/CCS- Remote

City/State

Norfolk, VA

Overview

Work Shift

First (Days) (United States of America)

Sentara is currently seeking a Claims Resolution Coder-Remote

This is a Full Time position with Day shift hours

Remote opportunities available in the following states:

Virginia, North Carolina, Alabama, Delaware, Florida, Georgia, Kansas, Idaho, Indiana, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington State, West Virginia, Wyoming, Wisconsin

Required Qualifications:

• High School Diploma or Equivalent

• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)

• 2 years Minimum of Billing Experience in Healthcare Setting -or-

• 2 Years Minimum of Coding Experience in Healthcare Setting -or-

• 2 years Minimum of Reimbursement/Adjudication/Denials Experience in Healthcare Setting

• Knowledge of CPT and HCPCS

• Knowledge of Medicare NCD and LCD guidelines

• Experienced in Microsoft Office

Preferred Qualifications:

• Associates Degree in Health Information Technology or Medical billing

• Knowledge of NCCI policy manual (Medicare)

Primary responsibilities include:

• 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.

As the third-largest employer in Virginia, Sentara Health was named by Forbes Magazine as one of America's best large employers.  We offer a variety of amenities to our employees, including, but not limited to: 

• Medical, Dental, and Vision Insurance

• Paid Annual Leave, Sick Leave

• Flexible Spending Accounts

• Retirement funds with matching contribution

• Supplemental insurance policies, including legal, Life Insurance and AD&D among others

• Work Perks program including discounted movie and theme park tickets among other great deals

• Opportunities for further advancement within our organization

Sentara employees strive to make our communities healthier places to live.  We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace.  For information about our employee benefits, please visit: Benefits - Sentara (sentaracareers.com)

Sentara Health offers employees comprehensive health care and retirement benefits designed with you and your family's well-being in mind. Our benefits packages are designed to change with you by meeting your needs now and anticipating what comes next. You have a variety of options for medical, dental and vision insurance, life insurance, disability and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave. Team Members have the opportunity to earn an annual flat amount Bonus payment if established system and employee eligibility criteria is met.

 

For applicants within Washington State, the following hiring range will be applied: $24.93(hourly) to $32.77(hourly).

Join our team! We are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, and growth!

Keywords: Certified Coding Specialist, Certified Professional Coder, Medical Billing and Coding, Medical Reimbursements, CPT Coder, HCPCS Coder, Medicare NCD, Medicare LCD, NCCI, CCS, CPC

Job Summary

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. Is additionally 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.

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.

Qualifications:

HS - High School Grad or Equivalent (Required)

Certified Coding Specialist (CCS) - Certification - American Health Information Management Association (AHIMA), Certified Professional Coder (CPC) - Certification - American Academy of Professional Coders (AAPC)

Billing, Coding, Reimbursement

Skills

Communication, Judgment and Decision Making, Microsoft Excel, Microsoft Word, Speaking, Time Management, Writing

Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.

In support of our mission “to improve health every day,” this is a tobacco-free environment.

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