Coding Analyst Sr.
Elevance Health
Coding Analyst Sr.
LOCATION: This is a virtual eligible role. You should be within a reasonable proximity to one of the posted locations.
HOURS: 8:00a - 5:00p, Monday through Friday (Eastern or Central time)
Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidates reside within a commuting distance from an office.
The Coding Analyst Sr. is responsible for reviewing, auditing, and coding medical records for the purpose of reimbursement, training, education and compliance.
Primary duties may include, but are not limited to:
- 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.
- Serves as a resource to Coding Analysts.
Required Qualifications
- Requires a H.S. diploma or equivalent and minimum of 2 years of experience; or any combination of education and experience, which would provide an equivalent background.
- Certified Medical Code (CPC or CCS-P) required.
Preferred Qualifications
- Experience with the most current CMS Risk Adjustment Model/version is strongly preferred.
- AAPC Certified Risk Adjustment Coder (CRC) is highly preferred.
- Knowledge of medical terminology and anatomy strongly preferred.
Job Level: Non-Management Non-Exempt
Workshift:
Job Family: MED > Licensed/Certified - Other
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