Claims Resolution Coder- Remote
City/State Norfolk, VA Work Shift First (Days) Overview: 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 Education Assoc Degree: Health Information Technology or Medical Billing preferred) High School Diploma or equivalent Certification/Licensure Coding CPC or CCS Certification (Required) Experience 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. We provide market-compensation packages, inclusive of base pay, incentives, and benefits. The base pay for Full Time employment, this position, is min $ 22.36 - max $ 37.26 per hour. 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. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!
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