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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