Coding Analyst Sr.

Elevance Health•Durham, NC

15h•Remote

About The Position

The Coding Analyst Sr. is responsible for reviewing, auditing, and coding medical records for the purpose of reimbursement, training, education and compliance. This is a virtual eligible role, meaning associates can work virtually full-time, with the exception of required in-person training sessions. Candidates must be within a reasonable proximity to one of the posted locations to be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Requirements

Requires a H.S. diploma or equivalent and minimum of 2 years of experience; or any combination of education and experience, which would provide an equivalent background.
Certified Medical Code (CPC or CCS-P) required.

Nice To Haves

Experience with the most current CMS Risk Adjustment Model/version is strongly preferred.
AAPC Certified Risk Adjustment Coder (CRC) is highly preferred.
Knowledge of medical terminology and anatomy strongly preferred.

Responsibilities

Audits and reviews medical documentation for appropriate ICD-9 and CPT coding and documentation.
Queries physicians when code assignments are not straightforward or documentation is unclear.
Trains and educates others on coding documentation, claim payment guidelines, and related issues.
Reviews CPT and ICD-9 codes annually for accuracy and implements changes.
Assists physicians and providers with questions and problems related to coding, documentation and billing.
Serves as a resource to Coding Analysts.