Medical Coding Education Associate Sr (Hospital / Professional Claims)
About The Position
Medical Coding Education Associate Sr (Hospital / Professional Claims) Hybrid 1: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location will not be considered for employment, unless an accommodation is granted as required by law. The Medical Coding Education Associate Sr is responsible for the comprehensive analysis of complex claims data to generate refined and industry-relevant concepts that govern the prosperity of the company across all business lines and client interactions. Engages with providers and other internal external stakeholders to ensure proactive collaboration in reviewing coding and documentation guidelines. Also examining medical records and various documentation to ensure the precision of code assignment. Researches, validates, and stays abreast of medical coding and billing issues, trends and changes in regulations and industry standards to recommend concepts. Develops concept ideas on their own to support the goals of the department and organization. Develop new leads and launch education concepts. Furnishes providers with comprehensive feedback on current year coding guidelines and industry expertise and assists other associates with their documentation and education discussions. Facilitated through phone and email correspondences to ensure that provider expresses clear understanding of coding and documentation guidelines for the applicable concept(s). Executes a detailed review of medical records to confirm whether the documentation justifies the level of service provided. Assists other associates with the completion of their medical record reviews and responds to provider inquiries. Completes appeals requests from providers. Completion of chart review and detailed education provided based on the records received,
Requirements
- Requires an AA/AS degree and a minimum of 6 years of experience working with ICD-9/10CM, CPT, and HCPCS coding; or any combination of education and experience, which would provide an equivalent background.
- Requires current, valid, active, and unrestrictive RHIA certification as a Registered Health Information Administrator and/or RHIT certification as a Registered Health Information Technician and/or CCS as a Cert Coding Specialist and/or CPC Cert Professional Coder.
Nice To Haves
- Proficiency with MS Outlook, Word and Excel strongly preferred.
- Experience in facility and professional health insurance reimbursement, medical coding or coding audits strongly preferred.
- Understanding of health data analytics preferred.
- Requires strong oral and written communication skills, excellent analytical and critical thinking skills, strong decision-making skills, ability to manage multiple tasks in a demanding work environment, appreciation of diversity, high energy level, and self-motivation.
Responsibilities
- Comprehensive analysis of complex claims data to generate refined and industry-relevant concepts.
- Engages with providers and other internal external stakeholders to ensure proactive collaboration in reviewing coding and documentation guidelines.
- Examining medical records and various documentation to ensure the precision of code assignment.
- Researches, validates, and stays abreast of medical coding and billing issues, trends and changes in regulations and industry standards to recommend concepts.
- Develops concept ideas on their own to support the goals of the department and organization.
- Develop new leads and launch education concepts.
- Furnishes providers with comprehensive feedback on current year coding guidelines and industry expertise and assists other associates with their documentation and education discussions.
- Facilitated through phone and email correspondences to ensure that provider expresses clear understanding of coding and documentation guidelines for the applicable concept(s).
- Executes a detailed review of medical records to confirm whether the documentation justifies the level of service provided.
- Assists other associates with the completion of their medical record reviews and responds to provider inquiries.
- Completes appeals requests from providers.
- Completion of chart review and detailed education provided based on the records received
Benefits
- Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
- We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
Number of Employees
5,001-10,000 employees
