Claims Resolution Coder

Sentara Hospitals•Norfolk, VA

1d•$22 - $37•Remote

About The Position

Claims Resolution Coder- Remote 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

Requirements

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

Nice To Haves

Associates degree in Health Information Technology or Medical Billing preferred

Responsibilities

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
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

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