Job Details

Claims Resolution Coder - Remote

Location: Norfolk, VA

Work Shift: First (Days)

Overview

Responsible for reviewing medical documentation to assign modifiers to insurance claims with issues identified by the National Correct Coding Initiative (NCCI), Medicare Outpatient Code Editor (OCE), or other third‑party payer specific claims processing guidelines. Works with Coding, Billing and Reimbursement staff to resolve edits. Is additionally responsible for trending errors, supporting identification of root causes, and effective communication with coding and training staff to improve coding accuracy and clean claims processing. Researches regulations to ensure accuracy of CPT codes and documentation.

Responsibilities

• Review medical documentation to assign modifiers to insurance claims under NCCI, OCE, and other payer guidelines.
• Work with Coding, Billing, and Reimbursement staff to resolve edits.
• Trend errors and support root‑cause analysis.
• Communicate with coding and training staff to improve coding accuracy.
• Research regulations to ensure accuracy of CPT codes and documentation.

Education

• Associate degree in Health Information Technology or Medical Billing (preferred).
• High School Diploma or equivalent.

Certification/Licensure

• CPC or CCS coding certification (required).

Experience

• 2 years direct application of coding, medical billing, or reimbursement in a healthcare setting, hospital or physician office (required).
• Thorough knowledge of lab, radiology and other ancillary, CPT, HCPCS‑related modifier and revenue codes, as well as Medicare NOD and LCD guidelines.
• Working knowledge of medical record documentation requirements and ability to interpret documentation.

Compensation and Benefits

We provide market‑compensation packages inclusive of base pay, incentives, and benefits. The base pay for full‑time employment for this position is min $22.36 - max $37.26 per hour. Additional compensation may be available for this role such as shift differentials, standby/on‑call, overtime, premiums, extra shift incentives, or bonus opportunities.

Benefits:

• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long‑Term, Short‑Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down – $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Opportunity to earn annual discretionary bonus if eligibility criteria is met.

EEO Statement

Sentara Health is an equal opportunity employer and prides itself on diversity and inclusiveness of its workforce.

In support of our mission “to improve health every day,” this is a tobacco‑free environment.

Remote work is available for associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.