Claims Resolution Coder/CPC/CCS- Remote

Sentara is currently seeking a Claims Resolution Coder-Remote

This is a Full Time position with Day shift hours.

Remote opportunities available in the following states:

Virginia, North Carolina, Alabama, Delaware, Florida, Georgia, Kansas, Idaho, Indiana, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington State, West Virginia, Wyoming, Wisconsin.

Required Qualifications:

• High School Diploma or Equivalent.
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS).
• 2 years Minimum of Billing Experience in Healthcare Setting -or-
• 2 Years Minimum of Coding Experience in Healthcare Setting -or-
• 2 years Minimum of Reimbursement/Adjudication/Denials Experience in Healthcare Setting.
• Knowledge of CPT and HCPCS.
• Knowledge of Medicare NCD and LCD guidelines.
• Experienced in Microsoft Office.

Preferred Qualifications:

• Associates Degree in Health Information Technology or Medical billing.
• Knowledge of NCCI policy manual (Medicare).

Primary responsibilities include:

• 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.

As the third-largest employer in Virginia, Sentara Health was named by Forbes Magazine as one of America’s best large employers. We offer a variety of amenities to our employees, including, but not limited to:

• Medical, Dental, and Vision Insurance.
• Paid Annual Leave, Sick Leave.
• Flexible Spending Accounts.
• Retirement funds with matching contribution.
• Supplemental insurance policies, including legal, Life Insurance and AD&D among others.
• Work Perks program including discounted movie and theme park tickets among other great deals.
• Opportunities for further advancement within our organization.

Sentara employees strive to make our communities healthier places to live. We’re setting the standard for medical excellence within a vibrant, creative, and highly productive

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