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Claims Edit Coder Jobs in Virginia (NOW HIRING)

People, Technology & Processes

$46.25 - $60.50/hr

... code comments and clearcode. * Build Proof of Concept / Early Adopter examples or graphical ... NTLM, Kerberos, Claims-Based, related configurations for SharePoint, Active Directory, Azure Active ...

People, Technology & Processes

... code comments and clearcode. * Build Proof of Concept / Early Adopter examples or graphical ... NTLM, Kerberos, Claims-Based, related configurations for SharePoint, Active Directory, Azure Active ...

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Claims Edit Coder information

What are the key skills and qualifications needed to thrive as a Claims Edit Coder, and why are they important?

To thrive as a Claims Edit Coder, you need a solid understanding of medical coding (ICD-10, CPT, HCPCS), claims processing, and healthcare regulations, typically supported by a coding certification such as CPC or CCS. Familiarity with electronic health record (EHR) systems, claims editing software, and payer-specific coding guidelines is crucial. Attention to detail, analytical thinking, and effective communication are vital soft skills for accurately identifying and resolving coding errors. These skills ensure correct claim submission, minimize denials, and support timely reimbursement for healthcare providers.

What are Claims Edit Coders?

Claims Edit Coders are healthcare professionals who review and analyze medical claims to ensure they are coded accurately and comply with insurance and regulatory guidelines. They use specialized coding systems, such as ICD-10, CPT, and HCPCS, to verify that procedures and diagnoses are properly documented. Their work helps prevent billing errors, reduce claim denials, and ensure timely reimbursement for healthcare providers. Claims Edit Coders often collaborate with billing departments and healthcare providers to resolve discrepancies and improve coding accuracy.

What is the difference between Claims Edit Coder vs Claims Processing Specialist?

AspectClaims Edit CoderClaims Processing Specialist
CertificationsCertified Coding Associate (CCA), CPCNone required, but certifications can be beneficial
Work EnvironmentHealthcare facilities, insurance companies, remoteInsurance companies, healthcare providers, office setting
Primary ResponsibilitiesReview and correct claim data, ensure coding accuracyProcess claims from submission to payment, handle inquiries

Claims Edit Coders focus on reviewing and correcting claim data to ensure accurate coding, while Claims Processing Specialists handle the overall processing of claims from submission to resolution. Both roles require knowledge of insurance policies and coding, but Claims Edit Coders are more specialized in coding accuracy, whereas Claims Processing Specialists manage broader claim workflows.

What are some common challenges faced by a Claims Edit Coder, and how can they be addressed?

Claims Edit Coders often encounter challenges such as staying updated with frequent changes in coding regulations and payer-specific requirements. Additionally, coding errors or discrepancies may arise due to incomplete or unclear documentation from providers. To address these issues, it's important to engage in ongoing education, actively communicate with clinical staff for clarification, and utilize reliable coding resources and software. Collaboration with team members and regular training can help maintain accuracy and compliance in claim submissions.
What are popular job titles related to Claims Edit Coder jobs in Virginia? For Claims Edit Coder jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Claims Edit Coder jobs in Virginia look for? The top searched job categories for Claims Edit Coder jobs in Virginia are:
What cities in Virginia are hiring for Claims Edit Coder jobs? Cities in Virginia with the most Claims Edit Coder job openings:
Claims Edit Coder jobs near you
SharePoint Subject Matter Expert (SME)

SharePoint Subject Matter Expert (SME)

People, Technology & Processes

On-site, Remote

$46.25 - $60.50/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 25 days ago

Job description

Job Title:SharePoint Subject Matter Expert (SME)Job Location:Fort Eustis, VA (Hybrid/Remote)Salary:Competitive, Depends on QualificationsClearance:SECRETTravel:Possible travel is anticipated
Purpose
People, Technology and Processes, LLC is seeking contractors to provide support to the TRADOC Enterprise KM Program. The goal of the TRADOC Enterprise KM Program is to create and implement the TRADOC KM strategy and improve organizational performance by establishing an environment and culture that efficiently shares knowledge, leverages data/content, and continuously innovates and improves work and business processes. The KM Program effectively harnesses the critical relationship between people, process, technology in the context of the organizational structure in creating, applying, organizing, and transferring know-how, experience, and expertise to support organizational learning and timely decision-making.
Responsibilities include, but are not limited to:
  • Provide SharePoint design, configuration, deployment, and maintenance support services.
  • Develops software solutions by studying requirements analysis and information needs; conferring with stakeholders and IT Management; studying systems flow, data usage, and work processes; performs software design using software development fundamentals and processes, debug, test, and deploy software solutions.
  • Execute within an Agile SDLCframework.
  • Design, develop and maintain key components of the software suite using SharePoint Server 2013/2016
  • Client-side web part development using the SharePoint Framework using JavaScript frameworks and tools such asTypeScript.
  • Implementation of SharePoint-based workflows as well as development of Business Intelligence dashboards
  • Documents and demonstrates solutions by developing documentation, flowcharts, layouts, diagrams, charts, code comments and clearcode.
  • Build Proof of Concept / Early Adopter examples or graphical simulation software. Then maintain product test software and demos for trainingpurposes.
  • Actively participate in Product Design Reviews by providing creative and practical ideas and solutions in a teamwork environment.
Required Education/Certifications:
  • Bachelor's degree (preferred)
Minimum Required Experience:
  • 10+ yrs. work experience dealing with communications/problemsolving.
  • Minimum of 5 years of experience with SharePoint/Microsoft 365.
  • Experience with authentication protocols: NTLM, Kerberos, Claims-Based, related configurations for SharePoint, Active Directory, Azure Active Directory, and web server (IIS)
  • Experience with Internet Information server (IIS) v8
  • Experience with Oracle, DB2, ASP, JavaScript, Java, .Net, Visual Basic, VBScript, PowerShell, HTML, XML, other Legal Research and Software Applications.
  • Experience with software development Unit Testing, System Testing, Functional Testing, User Acceptance Testing, or other development testing experience is preferred.
  • Experience with Software Development Life Cycle Process (may include SDLC, Agile, SCRUM, Lean, etc.)
  • Possess expert knowledge of SharePoint 2016, 2019 and SharePoint Online platform versions, and M365 full application suite to include but not limited Power Apps, PowerBI, Power Automate, TEAMS).
  • Hands-on experience with architecting SharePoint 2019 farms and migrating from SharePoint 2016 to SharePoint 2019.
  • Experience in SharePoint Development, including creating custom forms, workflows, and web parts.
  • Experience with SharePoint Online, including creating custom forms, tools, or reports with Power Apps, and creating workflows with Power Automate.
  • Ability to write or edit CSS and HTMLcode.
  • Knowledge of Microsoft (MS) Office, including MS Word, PowerPoint & Power BI
  • Excellent written and verbal communications skills
  • 5+ years of experience performing similar or comparable work in an environment of similar scale and complexity.
  • Candidates must demonstrate excellent verbal and written communication skills, with fluency in English equivalent to a native speaker.
  • Candidates must possess excellent communication skills and be able to communicate efficiently andeffectively.
  • Candidates must be able to work well with clients and team members of all levels notrequired.
  • Coordinate with various internal and/or external leaders to develop creative solutions, while adhering to project deadlines and budgets
  • Enjoys and works well collaborating with other designers and developers to achieve solid and well thought out web-based experiences.
About the company:
As a Service Disabled, Veteran Owned Small Business (SDVOSB) we are a provider of Information Technology (IT) professional services, software solutions and professional development training. Our core competencies evolved from leveraging IT enablers for knowledge management with an emphasis on Web Based Knowledge Portals and Portal Services, Server/System Services, SharePoint Development and System Administration and SQL Server Services. Our capabilities have expanded to include software development, technical training support and field support services.
Guiding Principles
  • Satisfy the customer - "Exceed expectations"
  • Set the Example - "Be out front"
  • Be Responsive - "Timing is everything"
  • Persevere - "Find a way"
Benefits
PTP offers a comprehensive benefits program:
  • Medical insurance
  • Dental insurance
  • Vision insurance
  • Supplemental benefits (Short Term Disability, Cancer & Accident).
  • Employer-sponsored Basic Life & AD&D Insurance
  • Employer-sponsored Value Adds - FreshBenies
  • 401(k) with matching
Holidays and Annual Leave
  • 11 Paid Holidays
  • 120 hours PTO accrual per year

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