Claims Solution Coder - Remote

Overview

The Claims Solution Coder utilizes their professional coding expertise to perform coding abstraction, reviews, and final validation of complex professional claims, while mentoring Claims Solution Specialists and collaborating with clinic leadership to enhance the claims process.

In Short

• Utilize certified coding expertise to resolve complex claims issues.
• Mentor and support Claims Solution Specialists in their daily duties.
• Develop tools and resources to aid Claims Solution Specialists.
• Conduct training sessions and provide helpline support.
• Create standing orders for managing claims.
• Engage with clinic leadership and providers for process improvement.
• Ensure accuracy and efficiency in the professional claims process.
• Participate in continuous improvement efforts.
• Maintain knowledge of advanced coding practices.
• Work in a collaborative environment with healthcare professionals.

Requirements

• CPC coding certification required.
• Professional coding or medical billing experience preferred.
• Advanced coding knowledge (e.g., CCI edits, appeal management).
• Root cause analysis experience is a plus.
• Strong communication skills for interaction with various stakeholders.
• Ability to perform manual dexterity tasks and frequent computer use.
• Ongoing need to assess customer needs effectively.
• Ability to mentor and guide team members.
• Knowledge of the insurance industry and claims processes.
• Commitment to continuous professional development.

Benefits

• Generous benefits package promoting wellness.
• Opportunities for professional development and education.
• Supportive work environment focused on employee well-being.
• Access to a wide range of health services.
• Equal opportunity employer committed to diversity.
• AI-enhanced recruitment process for better job matching.
• Tuition coverage for education goals through the PEAK program.
• Flexible work arrangements with telecommuting options.
• Engaging workplace culture fostering innovation and fulfillment.
• Commitment to fair and equitable pay practices.