Sr Certified Medical Coder RN
Company: Centene Corporation
Posted on: November 24, 2022
You could be the one who changes everything for our 26 million
members. Centene is transforming the health of our communities, one
person at a time. As a diversified, national organization, you'll
have access to competitive benefits including a fresh perspective
on workplace flexibility.
Position Purpose: The focus of this position is to establish
processes to respond to ICD-10 coding changes and its effect on
inpatient claims payment. Chart review will include DRG pre-payment
review, hospital readmission review and outlier payment review.
Analyze moderately complex health care information; reviews medical
records; integrate medical coding and reimbursement rules; provide
pricing guidance. Ensure medical coding rules and regulations
including compliance requirements are adhered to for the
appropriate handling of medical necessity, claims denials, and
bundling issues. Provide regular reports on project status and
progress; report project results to identify coding improvement
opportunities. Collaborate with other business units to identify
and implement process efficiency and quality improvement practices.
Work with IT resources to implement system efficiencies and
configuration enhancements to improve claims processing operations.
Apply Coding Guidelines as described in the ICD-10 Coding
Education/Experience: RN Degree. One year experience preferred in
hospital inpatient coding. Nursing experience in managed care
organization or acute care hospital.
License/Certification: CPC Credential-Required; Valid/Current CPC
Certification, through APPC-preferred; RHIA/RHIT
Credentials-Preferred. RN Degree.
For Fidelis Care only: CCS or CPC current Credential-Required
preferably credentialed by AHIMA or AAPC. RN Degree.
Our Comprehensive Benefits Package: Flexible work solutions
including remote options, hybrid work schedules and dress
flexibility, Competitive pay, Paid time off including holidays,
Health insurance coverage for you and your dependents, 401(k) and
stock purchase plans, Tuition reimbursement and best-in-class
training and development.
Centene is an equal opportunity employer that is committed to
diversity, and values the ways in which we are different. All
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, sexual orientation,
gender identity, national origin, disability, veteran status, or
other characteristic protected by applicable law.
**TITLE:** Sr Certified Medical Coder RN
**LOCATION:** Various, Texas
Keywords: Centene Corporation, Austin , Sr Certified Medical Coder RN, Healthcare , Austin, Texas
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