Apply on Employer Site

Centra Health · 6 hours ago

Sr. Professional Coder- Full time, Days, REMOTE

United States

Full-time

Remote

Mid, Senior Level

1+ years exp

Centra Health is seeking a Senior Professional Coder to join their team. The role involves reviewing clinical documentation and assigning appropriate codes to resolve claim edits and denials while ensuring compliance with coding guidelines.

Health CareHospitalMedicalOncology

H1B Sponsor Likely

Responsibilities

Reviews claims in assigned work queues in Cerner Revenue Cycle including CMG Review and Ambulatory Edit failure work items

Analyzes coding edits, reviews timeline notes, reviews clinical documentation, including provider orders, progress notes, surgical and test results thoroughly to interpret and ensure documentation supports the posted charges

Determines appropriate action needed to resolve coding edits/issues and ensure clean claim submission

Performs coding functions, including Current Procedure Terminology (CPT), International Classification of Diseases, tenth revision, Clinical Modification (ICD-10-CM), documentation review, and claim denial review

Applies appropriate modifiers

Ensures charges/coding are in alignment with the American Medical Association (AMA), Medicare, and Commercial coding guidelines on all claims reviewed

Credits /updates charges and coding as needed

Ensures queues are worked timely and efficiently

Maintains Productivity and accuracy requirements

Reports coding concerns, trends, and issues to leadership for investigation and resolution

Effectively communicates with clinical and billing staff to obtain and/or provide pertinent data to complete coding requirements for charge entry, claim submission and follow-up, or denial follow-up

Responds to inquiries from Customer Service in a timely and efficient manner and makes needed updates to coding, charges, and claims to help ensure prompt resolution of patient concerns

Maintains strict confidentiality of all information including patient data, Healthcare information, financial/operational and employee/human resources

Perform other duties as assigned

Qualification

Certified Professional Coder (CPC)Certified Coding Specialist (CCS)Registered Health Information Technician (RHIT)ICD-10-CMCPTRevenue Cycle ExperienceAutomated Revenue Cycle ManagementAnalytical abilitiesBilling guidelinesClinical documentation improvementProblem-solving skillsInterpersonal skillsVerbal communicationWritten communication

Required

Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Registered Health Information Technician (RHIT)

Minimum One Year Of Experience Within Revenue Cycle

Minimum one year of professional coding experience

Demonstrates working knowledge of third-party methodologies, various medical claim formats by passing competency assessment before hire

Demonstrates proficiency in International Classification of Diseases, Tenth revision, Clinical Modification ICD-10-CM and Current Procedural Terminology (CPT) by passing competency assessment before hire

Preferred

Experience with automated Revenue Cycle Management systems

Strong PC skills, including word processing and spreadsheets

Must have the ability to learn and utilize custom systems and applications

Strong problem-solving skills, analytical abilities, excellent interpersonal, verbal, and written communication skills

Knowledge of billing and regulatory guidelines as related to charging and other revenue cycle processes and ability to assist clinical departments and/or physician practices with changes to their charging practices based on guidelines

Knowledge of clinical documentation improvement processes

Company

Centra Health

Glassdoor3.3

Centra Health renders cancer care, health care, surgeons and hospital services.

Founded in 1987

Lynchburg, Virginia, USA

5001-10000 employees

https://www.centrahealth.com/

H1B Sponsorship

Centra Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (10)

2024 (5)

2023 (5)

2022 (14)

2021 (3)

2020 (1)