Sentara Health
Location
Richmond, Virginia
The Benefits Coding Analyst maintains the integrity of plan benefits for each program, developing expertise in all plan benefits while collaborating with various Health Plan teams to ensure compliance with state and Federal guidelines. This role synthesizes stakeholder input for benefit implementation decisions, coordinates benefit design documentation, and researches/codes policies for emerging treatments and services.
A Certified Professional Coder (CPC) certification is required, along with over two years of medical coding or billing experience specifically in areas like reimbursement, claims processing, or auditing. Preferred qualifications include an Associate Degree in Healthcare and a Certified Inpatient Coder (CIC) certification.
Sentara Health is looking to hire a Remote Benefits Coding Analyst. This position is remote however, candidates must be able to commute to our Richmond location. The Benefits Coding Analyst – Certified Professional Coder maintains the integrity of the plan benefits for each program and is responsible for developing an extensive expertise of all plan benefits. The Benefits Coding Analyst will work closely with multiple teams across the Health Plan, including but not limited to Claims, Compliance, Program, IT, and Health Services/Medical Management to ensure benefits are compliant with state and Federal guidelines, as well as aligned with Program benefit offerings. This position is responsible for synthesizing the input from multiple stakeholders to inform significant business decisions regarding benefit implementation as well as coordinating and maintaining benefit design documentation for the organization. The Benefits Coding Analyst will research, code, and assist with the development of benefit and utilization review policies and criteria for emerging treatments, technology, medications, and health plan services. This role will assist in researching code updates, authorization requests, and claim questions, updating business rules and benefit repositories as appropriate.
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