Coding And Reimbursement Specialist

Coding And Reimbursement Specialist

The Coding and Reimbursement Specialist is responsible for reviewing, auditing, and coding medical records for the purpose of reimbursement, training, education and compliance.

Location: Hybrid: 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(s) will not be considered for employment, unless accommodation is granted as required by law.

How You Will Make An Impact:

• Audits and reviews medical documentation for appropriate ICD-9 and CPT coding and documentation.
• Queries physicians when code assignments are not straightforward or documentation is unclear.
• Trains and educates others on coding documentation, claim payment guidelines, and related issues.
• Reviews CPT and ICD-9 codes quarterly for accuracy and implements changes.
• Assists physicians and operational staff with questions and problems related to coding, documentation and billing guidelines.
• Serves as a resource to reimbursement operations.

Minimum Requirements:

• Requires a H.S. diploma or equivalent and minimum of 2 years of experience; or any combination of education and experience, which would provide an equivalent background.
• Certified Medical Code (CPC or CCS-P) required.

Preferred Skills, Capabilities, and Experiences:

• Claims processing experience preferred.
• Knowledge of medical terminology and anatomy strongly preferred.

Job Level: Non-Management Non-Exempt

Workshift:

Job Family: MED > Licensed/Certified - Other

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 elevancehealthjobssupport@elevancehealth.com 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.