St. Luke's University Health Network is seeking a Certified Medical Coder to support clean claim submission and timely resolution of coding-related claim denials across professional services, FQHC, MSO, and ASC settings.
This role reviews provider documentation, queries, coding software tools, and payer medical and reimbursement policies to identify claim issues, correct coding errors, and support appeals when needed. The position is based in Allentown, PA with the opportunity for remote or hybrid work after at least 6 months on site, at manager discretion, for local Pennsylvania or New Jersey candidates only.
Schedule: Full-time, 40 hours per week, daytime hours, Monday through Friday.
Required certifications and experience
- CPC or CCA certification required
- At least 2 years of active E&M and/or surgical coding experience
- Comprehensive knowledge of ICD-10-CM, CPT, and HCPCS coding
- Experience working with third-party insurance companies related to claim processing and coding denials follow-up
- Epic Resolute experience preferred
Core responsibilities
- Maintain current knowledge of coding, compliance, and documentation guidelines
- Resolve charge review and claim edit CCI/LCD edits, diagnosis coding errors, and MUE frequency issues
- Correct or appeal coding denials using supporting documentation and payer policy
- Formulate appeal rationale based on clinical documentation and published coding guidance
- Provide coding guidance to providers and charge entry staff
- Track and document denial trends and root cause issues
- Review TCM Charge Review encounters for documentation support
- Assist with training new staff in Analyst role procedures
Location
Pennsylvania, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
4 weeks ago