Claims Resolution Coder/CPC/CCS- Remote

Sentara Health; Norfolk (VA); Remote; Full time

Job summary

An established industry player is seeking a Claims Resolution Coder to join their remote team. This role involves reviewing medical documentation, assigning modifiers, and ensuring compliance with coding standards. The ideal candidate will have a strong background in medical billing and coding, along with relevant certifications. You will work closely with a dedicated team to enhance coding accuracy and streamline claims processing. This position offers competitive compensation and a comprehensive benefits package, making it a great opportunity for professionals looking to advance their careers in healthcare coding.

Benefits

Medical, Dental, Vision plans

Paid Time Off and Sick Leave

401k/403B with Employer Match

Tuition Assistance

Pet Insurance

Legal Resources Plan

Emergency Backup Care

Paid Parental & Family Caregiver Leave

Student Debt Pay Down

Reimbursement for certifications

Qualifications

• 2 years of experience in coding and billing in a healthcare setting.
• CPC or CCS certification required at time of hire.

Responsibilities

• Review medical documentation to assign modifiers to insurance claims.
• Collaborate with staff to resolve coding and billing issues.

Skills

CPT Coding

Medical Billing

Claims Processing

Regulatory Research

Communication Skills

Education

High School Diploma

Associate Degree in Health Information Technology

Job description

Claims Resolution Coder/CPC/CCS- Remote

Claims Resolution Coder/CPC/CCS- Remote

Apply remote type Remote locations Sentara Patient Accounting time type Full time posted on Posted 6 Days Ago job requisition id JR-76872

City/State

Norfolk, VA

Work Shift

First (Days)

Overview:

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.

Minimum 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, as well as knowledge of Medicare NOD and LCD guidelines. Demonstrates working knowledge of medical record documentation requirements and ability to interpret documentation.

Education

• High School Diploma or equivalent
• Associate level degree preferred

Certification/Licensure

• Coding CPC or CCS Certification
• No specific certification or licensure requirements

Experience

• 2 years coding
• 2 years billing
• 2 years reimbursement
• Healthcare experience

We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is: $22.36 - $37.26. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Benefits: Caring For Your Family and Your Career

• 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.

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

In support of our mission “to improve health every day,” this is a tobacco-free environment.

For positions that are available as remote work, Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.