Provider Reimbursement Admin Sr- Behavior Health- Coding

About the role

The Provider Reimbursement Admin Sr is responsible for ensuring accurate adjudication of claims, by translating various coding, business and billing rules and standards into effective and accurate reimbursement policies. Serves as subject matter expert regarding reimbursement policies, edits, behavioral health standards, billing, and coding conventions.

Responsibilities

• Works with vendors and enterprise teams to develop enterprise reimbursement policies and edits, ensuring policies and edits do not conflict with Federal and state mandates.
• May lead the full range of provider reimbursement activities for a state(s).
• Led projects related to provider reimbursement initiatives.
• Serves as a mentor to less experienced administrators.

Requirements

• Requires a BA/BS degree and a minimum of 4 years related experience; or any combination of education and experience, which would provide an equivalent background.
• CPC-Certified Professional Coder strongly preferred.
• Behavioral health background strongly preferred.
• Strong written and verbal skills.
• Strong critical thinking and analytical skills.

Qualifications

• BA/BS degree
• Minimum of 4 years related experience
• CPC-Certified Professional Coder
• Behavioral health background

Skills

• Strong written and verbal skills
• Strong critical thinking and analytical skills

Benefits

For candidates working in person or virtually in the below location, the salary range for this specific position is $70,800 to $106,200. Location: Virginia

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).