Certified Coding Specialist

Profile

u003cpu003eu003cstrongu003eThis job exists to u003c/strongu003eefficiently, effectively, and accurately convert patient encounters into reimbursable claims for timely payment from Clinicau0026rsquo;s payer mix.u003c/pu003enu003cpu003eAccept charges, review, analyze, and code diagnostic and procedural information that determines Medicaid, Medicare, CHP , and private insurance payments.u0026nbsp; The position will require review of ICD-10-CM, CPT, CDT and HCPCS coding for procedures performed by Clinica Providers and Clinical team and documented in the Electronic Health Record (EHR).u003c/pu003enu003cpu003eu0026nbsp;u003c/pu003enu003cpu003eu003cstrongu003eESSENTIAL DUTIES AND RESPONSIBILITIES:u003c/strongu003eu003c/pu003enu003cpu003eThe key responsibilities of departmental ownership and accountability are as follows:u003c/pu003enu003cpu003eu0026nbsp;u003c/pu003enu003cpu003eu003cstrongu003eGeneral Leadershipu003c/strongu003eu003c/pu003enu003culu003enu003cliu003eMaintain a positive attitude and fun work environment for fellow staffu0026nbsp; resulting in teamwork and productive collaboration with the site Operations and Clinical teamsu003c/liu003enu003cliu003eOverall accountability for the execution of the encounter to claim conversion process at the assigned site (coverage for other sites as needed)u003c/liu003enu003cliu003eAct as the coding expert for the assigned clinical siteu003c/liu003enu003cliu003eAct as a positive representative, influencer, and valuable contributor to external organizations such as CCHN and NAHC when requestedu003c/liu003enu003c/ulu003enu003cpu003eu0026nbsp;u003c/pu003enu003cpu003eu003cstrongu003eOperational Objectivesu003c/strongu003eu003c/pu003enu003culu003enu003cliu003eMaximize Program Revenue:u003c/liu003enu003culu003enu003cliu003eMinimize claims cycle-times, defects and reworku003c/liu003enu003cliu003eEnsure accurate and complete coding dailyu003c/liu003enu003cliu003eEliminate Missing u0026amp; Incomplete encounters dailyu003c/liu003enu003c/ulu003enu003cliu003eProviding exceptional customer service to Clinicau0026rsquo;s providers, clinic operations team, patients and to the Finance teamu0026rsquo;s other internal customersu003c/liu003enu003c/ulu003enu003cpu003eu0026nbsp;u003c/pu003enu003cpu003eu003cstrongu003eExternal Reporting u0026amp; Complianceu003c/strongu003eu003c/pu003enu003culu003enu003cliu003eExecute daily workload within full compliance of state and federal billing regulationsu003c/liu003enu003c/ulu003enu003cpu003eu0026nbsp;u003c/pu003enu003cpu003eu003cstrongu003eContinuous Improvement Projectsu003c/strongu003eu003c/pu003enu003culu003enu003cliu003eSeeking opportunities to improve Billing and Financial Screening processes such as those to:u003c/liu003enu003c/ulu003enu003culu003enu003cliu003eIncrease productivityu003c/liu003enu003cliu003eIncrease accuracy u0026amp; reduce errors (Quality)u003c/liu003enu003cliu003eSave moneyu003c/liu003enu003cliu003eIncrease employee moraleu003c/liu003enu003c/ulu003enu003culu003enu003cliu003eAnalyzes provider documentation to assure the appropriate Evaluation u0026amp; Management coding levels are assigned along with the correct CPT, ICD and CDT code.u003c/liu003enu003cliu003eMeets with Providers and Clinical Staff on a daily basis to eliminate missing and incomplete coding on encounters.u003c/liu003enu003c/ulu003enu003culu003enu003cliu003ePerforms regular training, as needed for providers, clinical support staff, operations and billing staff.u003c/liu003enu003cliu003eProvides expertise to Billing staff in addressing appeals for denials of any incorrectly coded services performed..u003c/liu003enu003c/ulu003enu003cpu003eu003cstrongu003eu0026nbsp;u003c/strongu003eu003c/pu003enu003cpu003eu003cstrongu003eOTHER DUTIES AND RESPONSIBILITIES:u003c/strongu003eu003c/pu003enu003culu003enu003cliu003eWill maintain current certification throughout employmentu003c/liu003enu003cliu003eParticipates on committees and in meetings as directed by their Manageru003c/liu003enu003cliu003ePerforms other duties and responsibilities, as required.u003c/liu003enu003cliu003eAct as a positive Finance team representative and valuable contributor to Clinica.u003c/liu003enu003cliu003eMaintain a safe work environment by remaining informed of and compliant with the clinicu0026rsquo;s safety policies, and in particular by application of safe practices in area of own responsibility.u003c/liu003enu003cliu003eCompliance:u003c/liu003enu003cliu003eKnowledgeable of and compliant with all laws and regulations governing area of responsibility.u003c/liu003enu003cliu003eResponsible for reporting any potentially non-compliant conduct.u003c/liu003enu003cliu003eCooperate fully with our Compliance Officer in upholding our Compliance Planu003c/liu003enu003c/ulu003enu003cpu003eu0026nbsp;u003c/pu003enu003cpu003eu003cstrongu003eEducation / Experienceu003c/strongu003eu003c/pu003enu003colu003enu003cliu003eHigh school diploma or GED requiredu003c/liu003enu003cliu003eCurrently Certified through AAPC or AHIMA with a CPC-A or a CCA credentialu003c/liu003enu003cliu003e1-2 years of coding experience using ICD-10-CM, CPT, and HCPCS codes preferred.u003c/liu003enu003cliu003eCPT Coding experience desirable, but not required.u003c/liu003enu003cliu003eAdvance knowledge of medical terminology, abbreviations, techniques; anatomy and physiology; major disease processes; pharmacology; and the metric system to identify clinical findings, to support existing diagnoses, or substantiate listing additional diagnoses in the medical record.u003c/liu003enu003c/olu003enu003cpu003eu0026nbsp;u003c/pu003enu003cpu003eu003cstrongu003eKnowledge, skills and abilities:u003c/strongu003eu003c/pu003enu003colu003enu003cliu003eExperience with Next Gen EHR, EDR, and EPM a plus.u003c/liu003enu003cliu003eBasic knowledge of Microsoft Office, Word, Excel, Outlook, Zoom/Online Meeting platforms.u003c/liu003enu003cliu003eOffice skills including typing, accounting, 10 key entry, filing, computer terminal usage required.u003c/liu003enu003cliu003eKnowledge of various payment programs and insurers desired.u003c/liu003enu003cliu003eAbility to communicate to up line and down line staff in a professional and succinct manner.u003c/liu003enu003cliu003eCommunity Health Center office experience a plusu003c/liu003enu003c/olu003e,EqualOpportunityEmployerDescription:null,PayTransparencyPolicyStatement:null,MatchScore:1.0,HasApplied:false,ApplicationJobBoardName:null,ApplicationJobBoardId:null,DateApplied:null,Salaried:false,CompensationAmount:null,PublishingStatus:1,Links:[],BehaviorCriteria:[],MotivationCriteria:[],EducationCriteria:[],LicenseAndCertificationCriteria:[],SkillCriteria:[],WorkExperienceCriteria:[],JobBoardMemberships:[{JobBoardId:24c237ae-d249-4f95-a6b6-4c04e35b0855,PublishedInternal:false,PublishedExternal:true,ExternalPostedDate:2020-11-13T19:06:06.297Z,InternalPostedDate:null},{JobBoardId:87a3f19c-90bd-4c1f-a751-7e82f54015f3,PublishedInternal:true,PublishedExternal:false,ExternalPostedDate:null,InternalPostedDate:2020-11-13T19:06:06.297Z}],AssessmentUri:null,AssessmentStatus:null,OpportunityIsClosed:false,TravelRequired:null,TravelDescription:null,SupervisorName:null,Assessments:[],ApplicationId:null});

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