Certified Coding Specialist
Company: Clinica
Location: Lafayette
Posted on: May 16, 2022
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Job Description:
This job exists to efficiently, effectively, and accurately
convert patient encounters into reimbursable claims for timely
payment from Clinica's payer mix. Accept charges, review, analyze,
and code diagnostic and procedural information that determines
Medicaid, Medicare, CHP, and private insurance payments. The
position will require review of ICD-10-CM, CPT, CDT and HCPCS
coding for procedures performed by Clinica Providers and Clinical
team and documented in the Electronic Health Record (EHR).
ESSENTIAL DUTIES AND RESPONSIBILITIES: The key responsibilities of
departmental ownership and accountability are as follows: General
Leadership Maintain a positive attitude and fun work environment
for fellow staff resulting in teamwork and productive collaboration
with the site Operations and Clinical teams Overall accountability
for the execution of the encounter to claim conversion process at
the assigned site (coverage for other sites as needed) Act as the
coding expert for the assigned clinical site Act as a positive
representative, influencer, and valuable contributor to external
organizations such as CCHN and NAHC when requested Operational
Objectives Maximize Program Revenue: Minimize claims cycle-times,
defects and rework Ensure accurate and complete coding daily
Eliminate Missing & Incomplete encounters daily Providing
exceptional customer service to Clinica's providers, clinic
operations team, patients and to the Finance team's other internal
customers External Reporting & Compliance Execute daily workload
within full compliance of state and federal billing regulations
Continuous Improvement Projects Seeking opportunities to improve
Billing and Financial Screening processes such as those to:
Increase productivity Increase accuracy & reduce errors (Quality)
Save money Increase employee morale Analyzes provider documentation
to assure the appropriate Evaluation & Management coding levels are
assigned along with the correct CPT, ICD and CDT code. Meets with
Providers and Clinical Staff on a daily basis to eliminate missing
and incomplete coding on encounters. Performs regular training, as
needed for providers, clinical support staff, operations and
billing staff. Provides expertise to Billing staff in addressing
appeals for denials of any incorrectly coded services performed
OTHER DUTIES AND RESPONSIBILITIES: Will maintain current
certification throughout employment Participates on committees and
in meetings as directed by their Manager Performs other duties and
responsibilities, as required. Act as a positive Finance team
representative and valuable contributor to Clinica. Maintain a safe
work environment by remaining informed of and compliant with the
clinic's safety policies, and in particular by application of safe
practices in area of own responsibility. Compliance: Knowledgeable
of and compliant with all laws and regulations governing area of
responsibility. Responsible for reporting any potentially
non-compliant conduct. Cooperate fully with our Compliance Officer
in upholding our Compliance Plan Education / Experience High school
diploma or GED required Currently Certified through AAPC or AHIMA
with a CPC-A or a CCA credential 1-2 years of coding experience
using ICD-10-CM, CPT, and HCPCS codes preferred. CPT Coding
experience desirable, but not required. Advance knowledge of
medical terminology, abbreviations, techniques; anatomy and
physiology; major disease processes; pharmacology; and the metric
system to identify clinical findings, to support existing
diagnoses, or substantiate listing additional diagnoses in the
medical record. Knowledge, skills and abilities: Experience with
Next Gen EHR, EDR, and EPM a plus. Basic knowledge of Microsoft
Office, Word, Excel, Outlook, Zoom/Online Meeting platforms. Office
skills including typing, accounting, 10 key entry, filing, computer
terminal usage required. Knowledge of various payment programs and
insurers desired. Ability to communicate to up line and down line
staff in a professional and succinct manner. Community Health
Center office experience a plus Other Requirements COVID-19 Vaccine
(Required) Religious or Medical Exemptions available via
application process. Compensation: Approximately $22-$26 per hour.
All individual pay rates are calculated based on the candidate's
experience and internal equity. Clinica Family Health is an Equal
Opportunity Employer. We prohibit unlawful discrimination against
applicants or employees on the basis of age 40 and over, race,
color, religion, national origin, sex, disability, sexual
orientation, gender identity, or any other applicable status
protected by federal, state, or local laws.
Keywords: Clinica, Denver , Certified Coding Specialist, Other , Lafayette, Colorado
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