Medical Coder (CCS or CPC)

Job Description

A large health insurance company local to Philadelphia is looking to hire a medical coder to their Medical Policy team. This person will work with the clinical teams such as physicians & research analysts to develop the language of the policies. Once the medical policy is written this person will read the policy and apply medical codes (procedure, revenue, modifiers through the policies based on understanding and language within the policy). They will be responsible for partnering with the clinician team and bounce questions off of them to ensure proper coding to collaborate on the language and policy. Additional responsibilities will include:

* Collaborating with the medical team and develop a list of codes and policies (over 800+) policies. (The coder isn't responsible for the whole book but will work with the clinical coordinator and be assigned 35 to 40 policies and assigned to 2-3 research analysts, nurses or doctors)

* Develop code lists for benefit application, mandate application, and group exception requests.

* Work closely with the various areas including Legal departments, Sales and Marketing, Product Operations and other key area

* Reviews coding sources to recommend and develop comprehensive listings of appropriate codes in accordance with coding guidelines, national sources and established rules

* Revise coding within policies in accordance with committee, management, medical director recommendations, or based on revision to policy

* Serve as a resource to company associates regarding medical coding issues related to departmental documents, projects and inquiries.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to ~~~ .

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Skills and Requirements

-4+ years as a Medical Coder w/ experience inputting codes and adding procedure codes, modifyies, revenue codes etc

-Experience partnering with physicians writing claim policies following coding guidelines (experience coding the charts not just pulling codes)

-Background coding for multiple specialties: (radiology, OBGYN, Pathology, surgery, anesthesia, Emergency Room)

-4+ years with Professional coding (NO facility coding)

-MUST RESIDE IN NJ, PA OR DE - Cannot live in other states

-Coding certification MUST BE ACTIVE (CCS or CPC preferred) Bachelors degree null

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion,sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military oruniformed service member status, or any other status or characteristic protected by applicable laws, regulations, andordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to ~~~.