Benefits Coding Analyst
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Job Location:
Richmond, VA - USA
Monthly Salary:
Not Disclosed
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
City/State
Richmond VAWork Shift
First (Days)Overview:
Sentara Health is looking to hire a Remote Benefits Coding Analyst.
This position is remote however candidates must be able to commute to our Richmond location.
The Benefits Coding Analyst Certified Professional Coder maintains the integrity of the plan benefits for each program and is responsible for developing an extensive expertise of all plan benefits. The Benefits Coding Analyst will work closely with multiple teams across the Health Plan including but not limited to Claims Compliance Program IT and Health Services/Medical Management to ensure benefits are compliant with state and Federal guidelines as well as aligned with Program benefit offerings. This position is responsible for synthesizing the input from multiple stakeholders to inform significant business decisions regarding benefit implementation as well as coordinating and maintaining benefit design documentation for the organization. The Benefits Coding Analyst will research code and assist with the development of benefit and utilization review policies and criteria for emerging treatments technology medications and health plan services. This role will assist in researching code updates authorization requests and claim questions updating business rules and benefit repositories as appropriate.
Education:
- Associate Degree in Healthcare (preferred)
Certification:
Certified Professional Coder certification (CPC) (required)
Certified Inpatient Coder (CIC) (preferred)
Medical Assistant Certification (preferred)
Note: CIC is required for advancement to Level 2 and Level 3
Experience:
2 years of medical coding or billing experience specifically within reimbursement coding claims processing claims auditing and /or various payment methodologies (required)
Experience in both established benefit coding environments as well as experience in determination of coding requirements for new benefits (preferred)
Experience resolving billing and claims issues related to benefit to code assignment.
Thorough knowledge of anatomy and medical terminology
Expertise with NCCI (National Correct Coding Initiative) guidelines
Knowledge or direct experience processing Government program or commercial health claims for an MCO
Experience with ICD-10 CM CPT HCPCS QNXT.
Keywords: Talroo-Allied Health Healthcare Coding CPC CIC Billing Claims Auditing ICD-10 CM CPT HCPCS QNXT and Revenue coding in a managed care setting
Legal Resources Plan
Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30000-member workforce. Diversity inclusion and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission to improve health every day this is a tobacco-free environment.
For positions that are available as remote work Sentara Health employs associates in the following states:
Alabama Delaware Florida Georgia Idaho Indiana Kansas Louisiana Maine Maryland Minnesota Nebraska Nevada New Hampshire North Carolina North Dakota Ohio Oklahoma Pennsylvania South Carolina South Dakota Tennessee Texas Utah Virginia Washington West Virginia Wisconsin and Wyoming.
Required Experience:
IC
Key Skills
About Company
Sentara Health, is an integrated, not-for-profit health care delivery system in Virginia and North Carolina. Sentara improves health everyday.
