2 associate coder jobs found

City / State Norfolk, VA Work Shift First (Days) Overview :Sentara Health Plan is currently hiring an Associate Fraud and Abuse Investigator / Certified Professional Coder (CPC) Remote! Status :Full-time, permanent position (40 hours) Work hours :8am to 5pm EST, M-F Location :This position is remote for candidates that live in the following states :VA, NC, AL, DE, FL, GA, ID, IN, KS, LA, ME, MD, MN, NE, NV, NH, ND, OH, OK, PA, SC, SD, TN, TX, UT, WA, WV, WI, WY! With travel to Virginia Beach 1x a year.Job Responsibilities :Responsible for contributing to in-depth investigations for suspected fraud or abuse with respect to provider, pharmacy, employer, member, and broker interactions involving the full range of products.Responsible for contributing to the review of the quality of pharmacy, physician, ancillary and hospital based coding in routine desk audits as well as occasional on-site audits.Contribute to the review of reimbursement systems relating to health insurance claims...

City / StateNorfolk, VAWork ShiftFirst (Days)Overview :Claims Resolution Coder- RemoteResponsible 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.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,...