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

Crossroads Treatment Centers•Greenville, SC

2d•Hybrid

About The Position

Crossroads Treatment Centers is seeking a Hybrid Medical Coder (CPC or CCS-P) to join their team in Greenville, SC. Since 2005, Crossroads has been a leader in treating patients with opioid use disorder, providing accessible, high-quality, evidence-based medication-assisted treatment (MAT). This role involves assigning ICD-10-CM and CPT/HCPCS codes with modifiers for services provided in the facility, reviewing documentation from various providers, and ensuring diagnosis codes meet medical necessity guidelines. The Medical Coder will be knowledgeable of billing and coding requirements for different insurance payers, utilize coding resources for accuracy, and demonstrate technical competence with the facility encoder and EMR. Responsibilities also include resolving coding edits and denials, assisting with rebilling, maintaining knowledge of laws and regulations impacting compliant coding, and adhering to HIPAA regulations. The position requires meeting productivity and quality goals, including a 95% accuracy rate, and attending weekly team calls. The role also involves reporting coding patterns to management and staying current with coding guidelines and federal regulations. Interaction with providers and center administrators may occur regarding billing and documentation. Other duties related to medical coding compliance monitoring may be assigned by the Director of Medical Coding Compliance or Chief Compliance Officer.

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.

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.