Medical Coding Associate

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. 

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

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PRIMARY PURPOSE: To review medical codes, determine medical necessity of services and to review billing practices to ensure proper review for our clients.  

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Conducts coding reviews to ensure all documentation is accurate and follow coding guidelines and legal requirements.
• Reviews medical bills to ensure compliance with federal and state regulations regarding fair business practices.
• Reviews medical bills for pre-determination of services, treatment and relatedness.
• Serves as resource for client inquiries regarding billing and coding questions as it relates to down-coding of services.
• Reviews provider complaints due to improper billing.
• Works with billing department to ensure all bills are satisfied in a timely manner.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization's quality program(s).

QUALIFICATIONS

Education & Licensing
High school diploma or GED required. Medical Coding Certification CCA, CPC-A, or CPC required.

Experience
One (1) year of coding experience required, medical bill processing experience preferred.

Skills & Knowledge

• Knowledge of medical terminology
• Knowledge of state regulations and guidelines regarding billing and coding documentation and standards
• Excellent verbal and written communication skills
• PC literate, including Microsoft Office products
• Strong organizational skills
• Excellent interpersonal skills
• Ability to meet deadlines
• Ability to work in a team environment
• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: Clear and conceptual thinking ability; excellent …