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Certified Coding Specialist

Company: Clinica
Location: Lafayette
Posted on: May 16, 2022

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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