Healthcare Coding Specialist – Managed Care Contract Consultant

Sentara is looking to hire a Coding Specialist/Consultant who will be accountable to support coding requirements applicable to hospital, ancillary and physician contracting. This will include identification of appropriate coding for services within provider contracts, monitoring industry code updates and reporting impact to provider contracts, assigning appropriate code categories for each valid CPT/HCPCS code for fee schedule construction, monitoring CMS proposed/final rules for Medicare reimbursement changes and analyzing provider code requests during negotiations. This position is also accountable for assisting in reimbursement policy coding requirements to support reimbursement strategy for the organization.

 

Required Education:

  • CCS (preferred) or CCS-P certification from AHIMA
  • COC/CIC (preferred) or CPC certification from AAPC

 

Experience:

  • 3+ years coding experience using ICD-10-CM/PCS, CPT and HCPCS coding systems