Medical Coding Education Associate – Payment Integrity
| Company | Elevance Health |
|---|---|
| Location | Indianapolis, IN, USA, Mason, OH, USA, Norfolk, VA, USA, Atlanta, GA, USA |
| Salary | $Not Provided – $Not Provided |
| Type | Full-Time |
| Degrees | Associate’s |
| Experience Level | Mid Level, Senior |
Requirements
- Requires an AA/AS degree and a minimum of 4 year 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.
Responsibilities
- Engages with providers and other internal and external stakeholders to ensure proactive collaboration in reviewing coding and documentation guidelines. Examine 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.
- Conducts analyses of claims data to bolster the creation of educational concepts. Launch of education concepts.
- Provide providers with comprehensive feedback on current year coding guidelines and industry expertise, facilitated through phone and email correspondences to ensure that provider understands coding and documentation guidelines for the applicable concept(s).
- Execute a detailed review of medical records to confirm whether the documentation justifies the level of service provided. Completion of chart reviews and detailed education provided based on the records received.
Preferred Qualifications
- Proficiency with MS Outlook, Word and Excel.
- Experience in health insurance reimbursement, medical billing, medical coding, auditing, or health data analytics preferred.
- Strong oral and written communication skills, excellent analytical and problem-solving skills, strong decision-making skills, ability to manage multiple tasks in a demanding work environment, appreciation of cultural diversity, sensitivity towards target membership population, high energy level, self-motivated, and ability to handle several projects at a time.