Job Code: 600
Location: Commerce, CA
Program/Department: Billing Department
Reports To: Billing Supervisor
Salary Range: Staring salary based on experience, qualification, and budget. (100% time – 40 hours per week)
FLSA Status: Non-exempt
- Acts as the primary staff liaison between the providers and the Billing Dept.; and, effectively communicates to clarify diagnoses, procedures coding and documentation requirements.
- Recommends appropriate ICD-10-CM, CDT diagnosis codes, CPT codes and HCPC codes.
- Review diagnosis and procedure coding within NextGen, on a regular basis; and, ensure appropriate coding for optimal billing.
- Work closely with clinicians on appropriate use of ICD-10 codes to maximize HEDIS, HCC and other performance incentives that are submitted through claims data.
- In collaboration with Quality Insurance Team, ensures coding is appropriate to maximize Meaningful Use and other clinical incentive payments.
- Provide compliance and coding training for new providers, during their onboarding/orientation.
- Ensure that all codes are current and active.
- Code based on documentation with the medical record.
- Report missing or incomplete documentation.
- Evaluate and Assure that all codes are submitted to third party payers and IPA
- Serves as resource regarding insurance resolutions and coding questions.
- Follows coding guidelines and legal requirements to ensure compliance with federal and state regulations
- Supports the Billing Supervisor with improving current medical billing practices.
- Conduct monthly coding audits and maintain outcome reports up to date
- Ability to perform all other duties as assigned.
- High school degree or equivalent; Bachelor’s degree in related field preferred
- Medical Coding Certificate; RHIT or CPC by AAPC or AHIMA license; meet state licensure requirements
- Maintain coding certification and attends in-service training as required
- Two (2) years of medical coding experience
- Understanding of medical terminology, anatomy and physiology
- Ability to work independently or as an active member of a team
- Strong computer skills in data entry, coding, and knowledge of Electronic Medical Record software; Microsoft Office Suite
- Accurate and precise attention to detail
- Ability to multitask, prioritize, and manage time efficiently
- Excellent verbal and written communication skills
- Goal-oriented, organized team player