Sentara Health
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Claims Resolution Coder - Remote
role at
Sentara Health
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. 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.
Details City/State: Norfolk, VA
Work Shift: First (Days)
Responsibilities
Review medical documentation to assign modifiers to insurance claims with issues identified by NCCI, OCE, or other payer guidelines.
Collaborate with Coding, Billing and Reimbursement staff to resolve edits.
Trend errors and support identification of root causes; communicate findings to coding and training staff to improve coding accuracy and clean claims processing.
Research regulations to ensure accuracy of CPT codes and documentation.
Education & Experience
Associate degree in Health Information Technology or Medical Billing preferred.
2 years direct application of coding, medical billing or reimbursement in a health care setting (hospital or physician office) required.
Certification/Licensure
CPC or CCS Certification (Required) at time of hire.
Thorough knowledge of lab, radiology and other ancillary CPT, HCPCS related modifiers and revenue codes; knowledge of Medicare NOD and LCD guidelines.
Experience (continued)
Demonstrates working knowledge of medical record documentation requirements and ability to interpret documentation.
Education Minimum
High School diploma or equivalent
Associate degree preferred
Benefits
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
Student Debt Pay Down – $10,000
Reimbursement for certifications and free access to complete CEUs and professional development
Pet Insurance
Legal Resources Plan
Potential eligibility for annual discretionary bonus based on established criteria
Equal Opportunity Sentara Health is an equal opportunity employer
and prides itself on the diversity and inclusiveness of its workforce. Diversity, inclusion, and belonging guide the organization to reflect the communities it serves. This is a tobacco-free environment in support of our mission to improve health every day.
Remote work states : 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.
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Claims Resolution Coder - Remote
role at
Sentara Health
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. 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.
Details City/State: Norfolk, VA
Work Shift: First (Days)
Responsibilities
Review medical documentation to assign modifiers to insurance claims with issues identified by NCCI, OCE, or other payer guidelines.
Collaborate with Coding, Billing and Reimbursement staff to resolve edits.
Trend errors and support identification of root causes; communicate findings to coding and training staff to improve coding accuracy and clean claims processing.
Research regulations to ensure accuracy of CPT codes and documentation.
Education & Experience
Associate degree in Health Information Technology or Medical Billing preferred.
2 years direct application of coding, medical billing or reimbursement in a health care setting (hospital or physician office) required.
Certification/Licensure
CPC or CCS Certification (Required) at time of hire.
Thorough knowledge of lab, radiology and other ancillary CPT, HCPCS related modifiers and revenue codes; knowledge of Medicare NOD and LCD guidelines.
Experience (continued)
Demonstrates working knowledge of medical record documentation requirements and ability to interpret documentation.
Education Minimum
High School diploma or equivalent
Associate degree preferred
Benefits
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
Student Debt Pay Down – $10,000
Reimbursement for certifications and free access to complete CEUs and professional development
Pet Insurance
Legal Resources Plan
Potential eligibility for annual discretionary bonus based on established criteria
Equal Opportunity Sentara Health is an equal opportunity employer
and prides itself on the diversity and inclusiveness of its workforce. Diversity, inclusion, and belonging guide the organization to reflect the communities it serves. This is a tobacco-free environment in support of our mission to improve health every day.
Remote work states : 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.
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