Claritev
Role Overview
The Senior Medical Coding Specialist provides analysis of the highest dollar and most complex claims by applying research, coding standards, industry knowledge and federal regulations to ensure correct billing practices. This role requires familiarity with international coding systems and healthcare billing practices to support global operations and ensure alignment with international standards.
What You Will Do
Review and analyze complex inpatient, outpatient, and practitioner billing for medical appropriateness of treatment; assist management in daily operations and processes within the department; design and participate in clinical and coding education of coders, negotiators, and physicians.
Why It Might Be a Fit
This position requires a strong understanding of medical terminology, anatomy, and physiology, as well as excellent written, verbal, and listening communication skills. The ideal candidate will have 7+ years of experience in a clinically related field and current coding certification through AHIMA or AAPC.
Requirements
- Current coding certification through AHIMA or AAPC, or medical license such as RN or MD
- 7+ years of experience in a clinically related field
- Extensive knowledge of inpatient and outpatient hospital billing and claims data
- Extensive knowledge of international medical coding and data resources
- Knowledge of payer reimbursement policies, state and federal regulations, medical necessity criteria, and applicable industry standards
Benefits
- Medical, dental and vision coverage with low deductible & copay
- Life insurance
- Short and long-term disability
- Paid Parental Leave
- 401(k) + match
- Employee Stock Purchase Plan
- Generous Paid Time Off
- 10 paid company holidays
- Tuition reimbursement
- Flexible Spending Account
- Employee Assistance Program
- Sick time benefits
Originally posted on Himalayas
To apply for this job please visit himalayas.app.
Working in United States
The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic consisting of 50 states and a federal capital district, Washington, D.C. The 48 contiguous states border Canada to the north and Mexico to the south, with the semi-exclave of Alaska in the northwest and the archipelago of Hawaii in the Pacific Ocean. The United States also asserts sovereignty over five major island territories and various uninhabited islands in Oceania and the Caribbean. It is a megadiverse country, with the world's th
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