Medical Coding Education Associate Sr (Hospital Professional Claims)

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Medical Coding Education Associate Sr (Hospital / Professional Claims)

Hybrid 1: 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. This approach combines structured office engagement with the autonomy of virtual work promoting a dynamic and adaptable workplace. Alternate locations may be considered.

Please note that per our policy on hybrid/virtual work candidates not within a reasonable commuting distance from the posting location will not be considered for employment unless an accommodation is granted as required by law.

The Medical Coding Education Associate Sr is responsible for the comprehensive analysis of complex claims data to generate refined and industry-relevant concepts that govern the prosperity of the company across all business lines and client interactions.

• Engages with providers and other internal external stakeholders to ensure proactive collaboration in reviewing coding and documentation guidelines.

• Also examining medical records and various documentation to ensure the precision of code assignment.

• Researches validates and stays abreast of medical coding and billing issues trends and changes in regulations and industry standards to recommend concepts.

• Develops concept ideas on their own to support the goals of the department and organization.

• Develop new leads and launch education concepts.

• Furnishes providers with comprehensive feedback on current year coding guidelines and industry expertise and assists other associates with their documentation and education discussions.

• Facilitated through phone and email correspondences to ensure that provider expresses clear understanding of coding and documentation guidelines for the applicable concept(s).

• Executes a detailed review of medical records to confirm whether the documentation justifies the level of service provided.

• Assists other associates with the completion of their medical record reviews and responds to provider inquiries.

• Completes appeals requests from providers.

• Completion of chart review and detailed education provided based on the records received

Minimum Requirements:

• Requires an AA/AS degree and a minimum of 6 years of experience working with ICD-9/10CM CPT and HCPCS coding; or any combination of education and experience which would provide an equivalent background.

• Requires current valid active and unrestrictive RHIA certification as a Registered Health Information Administrator and/or RHIT certification as a Registered Health Information Technician and/or CCS as a Cert Coding Specialist and/or CPC Cert Professional Coder.

Preferred Qualifications:

• Proficiency with MS Outlook Word and Excel strongly preferred.

• Experience in facility and professional health insurance reimbursement medical coding or coding audits strongly preferred.

• Understanding of health data analytics preferred.

• Requires strong oral and written communication skills excellent analytical and critical thinking skills strong decision-making skills ability to manage multiple tasks in a demanding work environment appreciation of diversity high energy level and self-motivation.

For candidates working in person or virtually in the below locations the salary* range for this specific position is $69360 to $119646.

Locations: Costa Mesa CA; Woodland Hills CA; Denver CO; Columbus OH; Chicago IL; Hanover MD; Mendota Heights MN; Las Vegas NV; Latham NY; Seattle WA.

In addition to your salary Elevance Health offers benefits such as a comprehensive benefits package incentive and recognition programs equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender race or any other category protected by federal state and local pay equity laws.

*The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location work experience education and/or skill level. Even within the range the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned vested and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus commission benefits paid time off stock or any other form of compensation and benefits that are allocable to a particular employee remains in the Companys sole discretion unless and until paid and may be modified at the Companys sole discretion consistent with the law.

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Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes including those submitted to hiring managers are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy power our business outcomes and drive our shared success - for our consumers our associates our communities and our business.

We offer a range of market-competitive total rewards that include merit increases paid holidays Paid Time Off and incentive bonus programs (unless covered by a collective bargaining agreement) medical dental vision short and long term disability benefits 401(k) match stock purchase plan life insurance wellness programs and financial education resources to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager associates are required to work at an Elevance Health location at least once per week and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age citizenship status color creed disability ethnicity genetic information gender (including gender identity and gender expression) marital status national origin race religion sex sexual orientation veteran status or any other status or condition protected by applicable federal state or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws including but not limited to the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.