Join to apply for the Provider Reimbursement Adm-CPC role at Elevance Health .
Sign on Bonus: $1,000. 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. Alternate locations may be considered. This position is not eligible for employment sponsorship.
Responsibilities include ensuring accurate adjudication of claims by translating medical, reimbursement, and clinical editing policies into effective reimbursement criteria. PRIMARY DUTIES include reviewing medical record documentation for Evaluation and Management CPT codes, analyzing medical policies and editing rules, conducting clinical research and data analysis, translating policies into reimbursement rules, performing CPT/HCPCS code updates, coordinating research, responding to inquiries and appeals, auditing claims adjudication, and preparing correspondence regarding coding and fee schedule updates.
Minimum requirements: BA/BS degree and at least 2 years of related experience, or an equivalent combination of education and experience. Preferred skills include certification as a Professional Coder (CPC), CEMC, and CEDC.
Additional Details
- Seniority level: Entry level
- Employment type: Full-time
- Job function: Finance and Sales
- Industry: Hospitals and Health Care
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