CLAIMS RESOLUTION CODER

Location
Virginia Beach, VA
Posted
May 08, 2017
Closes
Jun 03, 2017
Function
Nurse
Industry
Healthcare
Hours
Full Time
Job Description:
Sentara Healthcare is seeking a full-time Claims Resolution Coder to work based out of our HIS-Landstown location in Virginia Beach, VA. careerconnection

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.

Education Level
High School Grad or Equivalent

Experience
Required: Billing - 2 years, Coding - 2 years, Reimbursement - 2 years

Preferred: None, unless noted in the “Other” section below

License
Required: Cert Coding Specialist, Cert Professional Coder

Preferred: None, unless noted in the “Other” section below

Skills
Required:

Preferred: None, unless noted in the “Other” section below

Other
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.