Coding Analyst Sr.

Elevance Health; North Carolina; Hybrid; USD 60,000 - 90,000; Full time

Job summary

Elevance Health is seeking a Coding Analyst Sr. to review, audit and code medical records for reimbursement, training and compliance. The role supports virtual eligibility with required in-person trainings and a hybrid work model.

Responsibilities include auditing documentation for ICD-9/CPT, querying physicians when unclear, training others, reviewing codes annually, and assisting providers with coding and billing questions. A CPC/CCS-P is required.

Qualifications

• Requires a HS diploma or equivalent and minimum of 2 years of experience; or any combination of education and experience providing equivalent background.
• Certified Medical Coder (CPC or CCS-P) required.

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.

Skills

ICD coding

CPT coding

Auditing

Training

Education

High school diploma or equivalent

Job description

Coding Analyst Sr.

LOCATION: This is a virtual eligible role. You should be within a reasonable proximity to one of the posted locations.

HOURS: 8:00a - 5:00p, Monday through Friday (Eastern or Central time)

Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not 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.

The Coding Analyst Sr. is responsible for reviewing, auditing, and coding medical records for the purpose of reimbursement, training, education and compliance.

Primary duties may include, but are not limited to:

• 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.

Required Qualifications

• 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.

Preferred Qualifications

• 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.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

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.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

Applicants who require accommodation to participate in the job application process may contact [e-mail] assistance.