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Medical Coding - Vendor and Claims Edit Specialist, Geisinger Health Plan (Pennsylvania resident)


PayCompetitive
LocationDanville/Pennsylvania
Employment typeFull-Time
  • 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

      We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
      We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.
  • About the company

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