- Oversee maintenance of medical coding changes in our Payment Integrity programs
- Research requests using multiple systems (including: Sales Force, Jira, NPS) to provide all available details to reviewer
- Use SalesForce, Jira, and NASCO claim systems, to perform functions such as initial claim review, outcome reporting, and distribution based on triage
- Correspond with providers regarding decisions about requested services and obtain medical records when necessary
- Review and respond to issues and questions from internal and external customers, both verbally and in writing
- Work collaboratively with other departments to obtain additional information to resolve inquiries
- Bachelor's degree, or equivalent combination of education and experience, with a minimum of 3 years' experience in medical coding; In-depth knowledge of CPT, ICD-9, ICD-10, HCPCS, DRG diagnosis and procedure coding
- Formal coding certification (eg: CPC, AAPC) is a must
- Experience with both professional and facility claims coding and in APC, HIPPS, or RUG coding and validation
- Health insurance (including vision)
- Dental coverage (free to employees)
- Wellness Program
- 401(k) with employer match + automatic employer contribution
- Life Insurance
- Disability Insurance
- Combined time off (CTO) – 20 days per year + 10 paid holidays
- Tuition Reimbursement
- Student Loan Repayment
- Dependent Caregiver Benefits
-
Medical Coding Specialist
1 day ago
BlueCross BlueShield of Vermont Montpelier, United StatesJob Description · Job DescriptionBlue Cross and Blue Shield of Vermont is looking for a Medical Coding Specialist to join our Payment Integrity team. Our company culture is built on an unwavering focus on our members and giving them the best service possible. We offer a balanced, ...
-
Medical Coding Specialist
4 days ago
BlueCross BlueShield of Vermont Montpelier, United StatesJob Description · Job DescriptionBlue Cross and Blue Shield of Vermont is looking for a Medical Coding Specialist to join our Payment Integrity team. Our company culture is built on an unwavering focus on our members and giving them the best service possible. We offer a balanced, ...
-
Finished Goods Specialist
1 week ago
Nolato AB Montpelier, United StatesJoin Nolato GW at our Bethel, Vermont plant We are looking for Finished · Goods Specialists. Perform final audit on boxes processed. Visually inspect product · for quality, quantity, lot number, part number and proper package. · Nolato GW is a global leader in precision injection ...
-
Software Engineering Manager
3 hours ago
Ford Motor Company Montpelier, United StatesFord Motor Company · Software Engineering Manager · Montpelier , · Vermont · Apply Now · Ford Pro is a new global business within Ford committed to commercial customer productivity. Ford Pro delivers a work-ready suite of vehicles, accessories, and services for virtually eve ...
-
Contracts Specialist
3 weeks ago
Management Solutions Montpelier, United StatesLocation field must contain 'city, state' or a zip code to perform a radius search (e.g., · Denver, CO · or · City and state must be separated by a comma followed by a space (e.g., · Houston, TX ) · Management Solutions · Contracts Specialist · in · Montpelier , · Vermont ...
-
District Manager, Cardiovascular
3 hours ago
J&J Family of Companies Montpelier, United StatesLocation field must contain 'city, state' or a zip code to perform a radius search (e.g., · Denver, CO · or · City and state must be separated by a comma followed by a space (e.g., · Houston, TX ) · J&J Family of Companies · District Manager, Cardiovascular (Boston North) · ...
-
Contracts Specialist
3 weeks ago
Management Solutions Montpelier, United StatesLocation field must contain 'city, state' or a zip code to perform a radius search (e.g., Denver, CO or City and state must be separated by a comma followed by a space (e.g., Houston, TX )Management Solutions Contracts Specialist in Montpelier , Vermont This opportunity is posted ...
-
Tax Fiscal Analyst
2 weeks ago
State of Vermont Montpelier, United StatesOverview · There has never been a better time to bring your values and talents to the collaborative team at the Vermont Department of Taxes. The rewarding work we do supports this brave little state and helps shape its future. We work with proven, dynamic technologies to fund ini ...
-
HR Specialist
3 weeks ago
Land O'Lakes Websterville, United StatesHR Specialist · The Human Resources Specialist will assist the People and Culture Manager and Plant Leadership in providing human resources support to all hourly employees and first point of contact for salaried employees at three Websterville, VT locations. · This position provi ...
-
Product Engineer, Software Development
3 weeks ago
Cardinal Health East Montpelier, United States**_What Application Development & Maintenance contributes to Cardinal Health_** · Application Development & Maintenance performs configuration or coding to develop, enhance and sustain the organization's software systems in a cross-functional team environment through adherence t ...
-
Technical Lead
2 weeks ago
RCN Capital South Windsor, United States**Primary Responsibilities**: · 1. Lead the global engineering team, implementing best practices, reviewing code standards, and ensuring a high degree of technical competence. · 2. Effectively collaborate with product owners and QA specialists to develop best-in-class, robust, an ...
-
Software Engineering Manager
2 weeks ago
TicketNetwork, Inc. South Windsor, United States**Job Overview & Function**: · This position is a hands-on managerial role that will also perform as a principal engineer/developer. You will play a crucial role in leading and managing a team of talented software engineers to develop high-quality solutions. You will be responsib ...
-
Activities Specialist
2 weeks ago
Gifford Health Care Randolph Center, United StatesLocation: · **Gifford Retirement Community** · - City: · **Randolph Center** · - State/Territory: · **US-VT** · - Job Code: · **2310** · - # of openings: · **1** · **Description**: · Gifford Retirement Community is seeking a Activities Specialist to work in our Randolph, VT locat ...
-
Finished Goods Specialist
1 week ago
Nolato AB Montpelier, United StatesJoin Nolato GW at our Bethel, Vermont plant We are looking for FinishedGoods Specialists. Perform final audit on boxes processed. Visually inspect productfor quality, quantity, lot number, part number and proper package.Nolato GW is a global leader in precision injection molding ...
-
Senior Developer
3 weeks ago
Oracle Montpelier, United StatesWe own the software design of our product, bringing questions and ideas to the table and analyzing them. We develop greenfield code for new applications as well as maintain a powerful legacy codebase. We become specialists in our business domain and take the time to deeply unders ...
-
Motor Vehicle Direct Client Service Specialist I
3 weeks ago
State of Vermont Montpelier, United StatesOverview · The Motor Vehicle Direct Client Service Specialist I is a fast-paced position that requires dealing with large numbers of customers every day. Candidates should be able to work independently and make informed decisions. Attention to detail is critical as work involves ...
-
Ford Pro Full Stack Software Engineer
1 week ago
Ford Motor Company Montpelier, United StatesFord Motor Company · Ford Pro Full Stack Software Engineer · Montpelier , · Vermont · Apply Now · At Ford Motor Company, we believe freedom of movement drives human progress. We also believe in providing you with the freedom to define and realize your dreams. With our incred ...
-
Senior Medical Stop Loss Underwriter
1 week ago
Highmark Health Montpelier, United StatesHighmark Health · Senior Medical Stop Loss Underwriter · Montpelier , · Vermont · Apply Now · This job prices quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ...
-
Senior Data Scientist
1 week ago
Highmark Health Montpelier, United StatesHighmark Health · Senior Data Scientist - AI Services and Platforms · Montpelier , · Vermont · Apply Now · Entirely Remote Work From Anywhere Role · We are seeking an experienced data science specialist to join our AI Services and Platforms team and drive the development of ...
-
National Director, Clinical Pharmacy- Remote
1 week ago
CenterWell Montpelier, United StatesLocation field must contain 'city, state' or a zip code to perform a radius search (e.g., · Denver, CO · or · City and state must be separated by a comma followed by a space (e.g., · Houston, TX ) · CenterWell · National Director, Clinical Pharmacy- Remote · in · Montpelie ...
Payment Integrity Coding Specialist - Montpelier, United States - BlueCross BlueShield of Vermont
Description
Job Description
Job DescriptionBlue Cross and Blue Shield of Vermont is looking for a Coding Specialist to join our Payment Integrity team. Our company culture is built on an unwavering focus on our members and giving them the best service possible. We offer a balanced, flexible workplace, an onsite gym, fitness and wellness programs, a competitive salary and full benefits package including medical and dental insurance, vision, 401k, paid time off and holidays, tuition reimbursement and student loan repayment, dependent caregiver benefits, and resources to support your ongoing personal and professional growth and development.REMOTE WORK: Blue Cross has transitioned to a hybrid workplace where employees within driving distance of our Berlin, VT office work Wednesdays in the office with flexibility to work remotely the rest of the week.
Coding Specialist Responsibilities:
Coding Specialist Qualifications:
Coding Specialist Benefits:
*Complete job description attached to ADP posting