Hybrid Medical Coder (CPC or CCS-P) - Greenville, SC

Crossroads Treatment Centers•Greenville, SC

1d•Hybrid

About The Position

Crossroads Treatment Centers is seeking a Hybrid Medical Coder (CPC or CCS-P) to join their team in Greenville, SC. Crossroads Treatment Centers is a leading provider of medication-assisted treatment (MAT) for opioid use disorder, with a mission to provide accessible, high-quality, evidence-based treatment options. The company operates outpatient clinics across multiple states and is committed to diversity and inclusion. The Medical Coder will be responsible for assigning ICD-10-CM and CPT/HCPCS codes with modifiers for services provided in the facility, reviewing documentation, ensuring medical necessity, and staying knowledgeable of billing and coding requirements for various insurance payers. This role requires technical competence in using coding encoders and EMR systems, resolving coding edits and denials, and maintaining a strong understanding of relevant laws and regulations, including HIPAA. The position also involves attending weekly team calls, reporting coding patterns, and staying current with coding guidelines and federal regulations. Interaction with providers and center administrators may be required. The role also includes other duties related to medical coding compliance monitoring as requested by management.

Requirements

Certified Professional Coder (CPC®) or CCS-P
High School diploma, GED or equivalent.
Minimum of 2 years of coding experience with an emphasis in Evaluation and Management coding.
Experience in coding healthcare provider documentation to identify correct ICD-10-CM, CPT, and/or HCPCS codes preferred.
An excellent understanding of Mental Health / Opioid Addiction medical terminology preferred.
An excellent understanding of ICD-10-CM coding classification and CPT/HCPCS coding.
Computer literate adept skill level on MS Office applications.
Candidates must work 8-hour shifts Monday through Friday.
Candidates may clock in as early as 6:30 AM EST , but no later than 9:00 AM EST .

Nice To Haves

Experience in Mental Health or Addiction Medicine a plus.

Responsibilities

Assign ICD-10-CM and CPT/HCPCS codes with modifiers for services provided in the facility (Professional fee coding).
Review all applicable documentation of various providers to determine the appropriate codes to assign for all medical services, procedures, and diagnoses from available documentation within electronic medical records.
Ensures diagnosis codes meet local and national medical necessity guidelines.
Be knowledgeable of billing and coding requirements for governmental and private insurance payers.
Utilize coding resources along with any other applicable reference material available to ensure accuracy in coding for all assigned services.
Demonstrates the technical competence to use the facility encoder and EMR in an office or remote setting.
Review and resolves coding edits and denials.
Assists with rebilling accounts when necessary.
Maintain a working knowledge of various laws, regulations and industry guidance that impact compliant coding.
Follow all HIPAA regulations and uphold a higher standard around privacy requirements.
Completes all assigned work in a timely manner based on internal and/or payer standards.
Must meet all coder productivity and quality goals; Maintain a 95% accuracy rate.
Attending and reporting at weekly team calls with Director of Medical Coding Compliance.
Reporting coding patterns identified within the coding process to management.
Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-10 materials, the Federal Register, and other pertinent materials.
Adhere to all internal competencies, behaviors, policies and procedures to ensure efficient work processes.
May interact with providers and/or center administrators from time to time regarding billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation.
Other duties and responsibilities pertaining to medical coding compliance monitoring as requested by the Director of Medical Coding Compliance or Chief Compliance Officer.