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Certified Coding Specialist

Company: Clinica Family Health Services
Location: Lafayette
Posted on: June 15, 2019

Job Description:

This job exists to: efficiently, effectively, and accurately convert patient encounters into reimbursable claims for timely payment from Clinica's payer mix.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 billing and 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:o Minimize claims cycle-times, defects and reworko Ensure accurate and complete coding dailyo 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 customersExternal Reporting& Compliance--- Execute daily workload within full compliance of state and federal billing regulationsContinuous Improvement Projects--- Seeking opportunities to improve Billing and Financial Screening processes such as those to:o Increase productivityo Increase accuracy& reduce errors (Quality)o Save money o Increase employee morale--- Analyzes provider documentation to assure the appropriate Evaluation& Management coding levels are assigned the correct CPT or 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.--- Reviews Charge Table for accuracy with"encounter rate" billing for FQHC's under the Medicaid and Medicare programs. Assists Director of Site Billing and Patient Eligibility and Manager of Reimbursement and Billing Analysis with any outside audit requests; reviewing requested information prior to sending.--- Reviews Charge Tables for CPT, CDT, and ICD-9-CM accuracy and compliance.--- Provides expertise to Billing staff in addressing appeals for denials for incorrect diagnosis's for services preformed.OTHER DUTIES AND RESPONSIBILITIES:--- Will maintain current certification throughout employment--- Will become certified in ICD-10-CM--- 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:o Knowledgeable of and compliant with all laws and regulations governing area of responsibility.o Responsible for reporting any potentially non-compliant conduct.o Cooperate fully with our Compliance Officer in upholding our Compliance PlanA. Education / Experience1. High school diploma or GED required2. Currently Certified through AAPC or AHIMA with a CPC-A or a CCA credential3. 1-2 years of coding experience using ICD-9-CM, CPT, and HCPCS codes preferred.4. CDT Coding experience desirable, but not required.5. 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.B. Knowledge, skills and abilities:1. Experience with Next Gen EHR, EDR, and EPM a plus.2. Office skills including typing, accounting, 10 key entry, filing, computer terminal usage required.3. Knowledge of various payment programs and insurers desired.4. Ability to communicate to up line and down line staff in a professional and succinct manner.5. Community Health Center office experience a plus

Keywords: Clinica Family Health Services, Denver , Certified Coding Specialist, Other , Lafayette, Colorado

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