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Certified Medical Coder

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

Position Purpose:

Principal Responsibilities:

  • 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.

Requirements:

  • 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

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The Health Resources and Services Administration (HRSA) consider JWCH Institute, Inc. / Wesley Health Centers and its providers as Public Health Services employees, providing malpractice liability protection under the Federal Tort Claims Act (FTCA). This health center is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n).

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