Claims Resolution Coder- Remote

Sentara Health

122d • $22 - $37

About The Position

Claims Resolution Coder 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.

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.
• Knowledge of Medicare NOD and LCD guidelines.
• Demonstrates working knowledge of medical record documentation requirements and ability to interpret documentation.

Nice To Haves

• Associate degree in Health Information Technology or Medical Billing preferred.

Responsibilities

• Review medical documentation to assign modifiers to insurance claims.
• Work with Coding, Billing and Reimbursement staff to resolve edits.
• Trend errors and support identification of root causes.
• Communicate effectively with coding and training staff to improve coding accuracy.
• Research regulations to ensure accuracy of CPT codes and 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
• Annual discretionary bonus if established system and employee eligibility criteria is met.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees