Certified Medical Coder at Insight Global Philadelphia, PA

Certified Medical Coder job at Insight Global. Philadelphia, PA.

• **100% remote currently but must be available to commute to Philadelphia Tues, Weds, Thurs** if/when the team returns to office.***
• *Medical Coding Certification required** - CCS or CPC preferred

JOB DESCRIPTION:

A large health insurance company local to Philadelphia is looking to hire a medical coder to their Medical Policy team. This person will work with the clinical teams such as physicians & research analysts to develop the language of the policies. Once the medical policy is written this person will read the policy and apply medical codes (procedure, revenue, modifiers through the policies based on understanding and language within the policy). They will be responsible for partnering with the clinician team and bounce questions off of them to ensure proper coding to collaborate on the language and policy. Additional responsibilities will include:

• Collaborating with the medical team and develop a list of codes and policies (over 800+) policies. (The coder isn't responsible for the whole book but will work with the clinical coordinator and be assigned 35 to 40 policies and assigned to 2-3 research analysts, nurses or doctors)
• Develop code lists for benefit application, mandate application, and group exception requests.
• Work closely with the various areas including Legal departments, Sales and Marketing, Product Operations and other key area
• Reviews coding sources to recommend and develop comprehensive listings of appropriate codes in accordance with coding guidelines, national sources and established rules
• Revise coding within policies in accordance with committee, management, medical director recommendations, or based on revision to policy
• Serve as a resource to company associates regarding medical coding issues related to departmental documents, projects and inquiries.