Medical Coding Specialist
About The Position
Provides documentation review, coding, and data abstracting of medical/behavioral health service documentation to ensure that Pueblo Community Health Center receives appropriate reimbursement and conforms to applicable guidelines and regulations. Accurate and timely coding, abstracting of clinical information which is used for reimbursement purposes, quality improvement efforts and reporting for internal and external purposes. Serves as a technical coding expert. The role is responsible for ICD-10, CPT and HCPC coding of all clinical and hospital service in a timely filing manner with a 95% accuracy rate. The right person for this job will be extremely detail-oriented and accurate. You must have the ability to work independently and communicate effectively with your team.
Requirements
- High School Degree or equivalent
- One year experience with outpatient or inpatient coding using ICD-10, CPT-4, and HCPCS for Medicare, Medicaid and third-party billing required, two years preferred.
- Demonstrated ability to understand the clinical content of a health record.
- Must be able to work with a variety of healthcare professionals at all levels.
Nice To Haves
- AAPC or AHIMA certification preferred
- An equivalent combination of education/certification and experience may be substituted.
- Working knowledge of electronic medical record systems preferred.
- A working knowledge of OBGYN, podiatry, inpatient, family practice and behavioral health
- A working knowledge of Local Coverage Determinations, National Coverage Determinations and NCCI guidelines for coding accuracy helpful.
Responsibilities
- Ensure the function and activities of this department to embrace the philosophy, mission, values, and Communicate with Heart service model supported by the Board of Directors of Pueblo Community Health Center, Inc.
- Adhere to the guidelines and procedures of Pueblo Community Health Center, Inc.
- Investigates, reviews, and provides clinical and/or coding expertise in the application of medical, behavioral health and reimbursement policies.
- Communicates with clinical staff to resolve coding issues in a timely manner.
- Communicates with clinical staff to resolve encounters with no coding attached to ensure timely filing of claims.
- Corrects and resubmits claims based on review of the medical record.
- Provides support to clinical staff by answering coding questions and assisting providers in the selection of codes for complex cases and issues.
- Works with Patient Accounts staff to resolve coding related denials
- Research problems and answers questions pertaining to coding.
- Maintains current knowledge of coding conventions, guidelines, updates, and regulations governing government and third-party billing
- Communicates with the Medical Coding Supervisor to provide feedback regarding documentation issues or reoccurring errors.
- Must meet and maintain departmental quality and production standards
- Must maintain all certifications required by this position
- Participates as needed in testing and training of new or existing systems
- Perform other related duties as assigned
Benefits
- Medical Insurance
- Dental Insurance
- Vision Insurance
- Long-Term Disability Insurance
- Short-Term Disability Insurance
- Life Insurance
- 403(b) Tax-Sheltered Annuity Plan
- Cafeteria 125 Flexible Spending Account
- supplemental insurances
- generous paid time off benefits including holidays and personal time off (PTO)
- contributes to the employee’s tax-sheltered annuity plan after one year of service.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
