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Medical Coding - Vendor and Claims Edit Specialist, Geisinger Health Plan (Pennsylvania resident)
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Job Description
- Req#: R-89510
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $(amount)
- Opportunity for career advancement and growth within the organization
- Work remotely from anywhere in Pennsylvania
- Comprehensive healthcare benefits available from day one, including vision and dental
- Supportive and collaborative work environment fostering teamwork and innovation
- Chance to mentor and develop less experienced staff and new hires
What to Expect (Job Responsibilities):
- Act as a leader and resource while collaborating with management, physicians, and clinical personnel
- Apply knowledge of CPT, ICD-10, and HCPCS coding to maintain and develop claim edits
- Research and clarify coding issues and determine payment compliance
- Lead the Edit Expansion Committee and oversee vendor partnership meetings
- Mentor less experienced staff and compile performance reports for vendor initiatives
What is Required (Qualifications):
- Minimum of 5 years of related work experience
- High School Diploma or Equivalent (GED) required
- Certification as a Certified Professional Coder (CPC) or Certified Professional Biller through AAPC
- Extensive knowledge of coding standards and compliance policies
- Ability to problem-solve system and claim edit issues
How to Stand Out (Preferred Qualifications):
- Graduate from a Specialty Training Program
- Minimum of 5 years of experience in Health Insurance/Managed Care
- Experience with ClaimsXten Policy Management Module development
- Proven ability to interact effectively with providers and Account Managers
- Familiarity with performance reporting for vendor initiatives
#HealthcareServices #Coding #RemoteWork #CareerOpportunity #Mentorship
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