Certified Coder

Columbia Valley Community Health Center•Wenatchee, WA

50d•$24 - $36•Hybrid

About The Position

The Coder's primary job function is to certify accurate billing for professional services and hospital procedures. This is accomplished through review of clinical encounters, confirming correct use of diagnosis and procedural codes and application of appropriate modifiers and CCI edits. The Coder provides education to providers to ensure proper completion of the medical record.

Requirements

High School Diploma or equivalent
AAPC Certification (American Academy of Professional Coders).
One year of coding experience in a healthcare setting preferred.
Knowledge of computer applications and equipment related to work. Must have basic computer and keyboarding skills and have the ability to enter data within company's computer system to include strong knowledge in MS Word/Excel; must demonstrate manual dexterity.
Strong interpersonal and communication skills and the ability to work effectively with other staff and management.
Ability to demonstrate personal integrity in all interactions.
Ability to make decisions in line with state and federal regulations; ability to read, comprehend, and analyze documents, regulations, and policies; ability to prepare and submit complete and succinct documents necessary to the job. Ability to assess and evaluate, have attention to detail.
Essential Sensory Requirements: Essential sensory requirements include the ability to: read computer keyboard, monitor, and documents; prepare and analyze documents; read extensively; see, recognize, receive and convey detailed information orally, by telephone and in person; convey accurate and detailed instructions by speaking to others in person and by telephone.

Nice To Haves

Strongly prefer knowledge of diagnosis and procedural coding, medical terminology and insurance billing guidelines, fluent with industry X12 and ANSI guidelines, proficient with claims adjustment reason and remark codes (CARC and RARC), FQHC certification or billing experience.
Exhibit strong customer service skills, strong process improvement background.
Demonstrated skill in developing and maintaining productive work teams.
Knowledge of auditing and compliance procedures, quality assurance and improvement practices, understanding of the elements of sponsored clinical protocols including consent forms, and reporting requirements. Problem solving and analytical skills are required with a heavy emphasis on detailed analysis of information to support actions.

Responsibilities

Reviews clinical encounters presented via electronic lists to ensure proper submission of services prior to billing.
Receives and reviews paper fee slips for hospital services and ensures proper coding of diagnosis and procedural codes.
Utilizing approved methods, communicates incorrect application of procedure or diagnosis codes or incomplete medical documentation to providers.
Meets on a regular basis with providers and clinical staff (for their assigned specialties) for the purpose of educating them on coding rule changes and/or coding trends and to answer coding questions
Is responsible to remain current with general billing guidelines, reimbursement rules and regulations.
Provides information as needed for production reporting and to ensure job standards are consistently met or exceeded.
Assists with internal audits by providing requested information and participating in review finding discussions regarding insurance processing performance. Submits to remedial training if substandard performance is identified through such audits.
Assists co-workers and management with special projects related to claims or A/R clean- up efforts.
To ensure uninterrupted service, participates in cross-training efforts and provides coverage for insurance processing and follow-up needs with non-assigned payers.
Actively participates in departmental and/or organizational process improvement (lean) initiatives.
Notifies management of audit requests by insurance payers and complies with requests in a timely manner.
Performs other duties and tasks as assigned by supervisor.
Expected to meet attendance standards and work the hours necessary to perform the essential functions of the job.
Conforms to safety policies, general housekeeping practices.
Demonstrates sound work ethics, flexible, and shows dedication to the position and the community.
Demonstrates a positive attitude, is respectful, and possesses cultural awareness and sensitivity toward clients and co-workers.
Keeps customer service and the mission of the organization in mind when interacting with all clients, co-workers, and others.
Employees are expected to embrace, support and promote the core values of respect, integrity, trust, compassion and quality which align with the CVCH mission statement through their actions and interactions with all patients, staff, and others.
Conforms to CVCH policies and Joint Commission and HIPAA regulations.