Code Edit Disputes Medical Coder
HumanaSalary not specified
Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries
Requirements
- H.S. diploma or equivalent and minimum of 1 year of experience; or any combination of education and experience which would provide an equivalent background
- Certified Medical Coder (CPC or CCS-P) required
- Reside in Puerto Rico
- Flexible to work first shift Monday through Friday and accommodate US States time zones
Responsibilities
- 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 annually for accuracy and implements changes
- Assists physicians and providers with questions and problems related to coding, documentation, and billing
Skills
ICD-9
CPT
Medical Coding
Medical Auditing
Documentation Review
Coding Compliance
Physician Querying
Claim Guidelines
Elevance Health
Integrated health services and digital platform
About Elevance Health
Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.
Indianapolis, IndianaHeadquarters
1944Year Founded
$309.4MTotal Funding
IPOCompany Stage
Enterprise Software, Social Impact, HealthcareIndustries
10,001+Employees
Benefits
Medical, dental, & vision insurance
401(k) + match
Paid holidays
Paid Time Off
Incentive bonus programs
Stock purchase plan
Life insurance
Wellness Programs
Financial education resources
Adoption & Surrogacy Assistance
Dependent-care Flexible Spending Account (DCFSA)
Parental Leave
Parental Transition Week
Critical Caregiving Leave
Risks
Departure of CFO John Gallina may create a gap in financial leadership.
Lawsuit against CMS over MA Star Ratings could lead to financial penalties.
CareBridge integration may face operational challenges, disrupting service delivery.
Differentiation
Elevance Health integrates whole health approach with digital health platform for comprehensive care.
Acquisition of CareBridge enhances home health services within Carelon division.
Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.
Upsides
AI integration in home health services can reduce hospital readmissions and improve outcomes.
Predictive analytics support early disease detection, aligning with Elevance's whole health approach.
Telehealth expansion offers opportunities to reach more patients remotely.
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