Claims Resolution Coder/CPC/CCS- Remote

Company: Sentara Healthcare Inc
Location: Norfolk
Posted on: May 3, 2025

Job Description:

OverviewResponsible 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. 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.Minimum Qualifications:

• Associates degree in Health Information Technology or Medical Billing preferred.
• 2 years direct application of coding, medical billing, or reimbursement in a healthcare 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
  • High School Diploma or equivalent
  • Associate level degree preferredCertification/Licensure
    • Coding CPC or CCS Certification
    • No specific certification or licensure requirementsExperience
      • 2 years coding
      • 2 years billing
      • 2 years reimbursement
      • Healthcare experience
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Keywords: Sentara Healthcare Inc, Newport News , Claims Resolution Coder/CPC/CCS- Remote, Other , Norfolk, Virginia