Department:Third Party Billing
at least 5+ years of relevant experience required
The Certified Professional Coder is responsible for correctly coding healthcare claims in order to obtain reimbursement from insurance companies and government healthcare programs, such as Medicaid and Medicare. This position participates in the preparation and coordination of internal and external reviews and requires knowledge and understanding of Connecticut and Federal regulations, Medicaid and the Joint Commission as utilized in conducting internal reviews to validate Clinic compliance.
EDUCATION AND EXPERIENCE/QUALIFICATIONS
High school graduate or GED equivalent plus current CPC or CCS-P coding certification required. Two plus years of experience in medical coding is required. Excellent verbal and written communication skills and proficiency in Microsoft office software is required.
Knowledge of Connecticut and Federal regulations, Medicaid requirements and the Joint Commission standards and activities is preferred. Knowledge or experience in a Federally Qualified Health Center (FQHC) is preferred. Strong background in medical, behavioral health and dental billing and the ability to learn new billing systems quickly preferred.
Wheeler provides equitable access to innovative care that improves health, recovery and growth at all stages of life.
Wheeler Clinic offers access to a comprehensive array of benefits, including:
For Good Health
· Anthem Medical, Prescription, Dental and Vision insurance
· Health Savings Account (HSA), with company contribution of $500 per year
· Wellness Programs
· Free annual flu shots
For a Secure Future
· Company paid Life and AD&D insurance
· Company paid long-term disability insurance
· 403(b) Plan, with clinic contributions for eligible employees
For Career Advancement
· Education Reimbursement Program
· Training and development opportunities
For Work Life Balance
· Generous paid time off, including vacation, sick and personal leave
· Employee Assistance Program (EAP)- Free and confidential counseling
· Employee discounts at local spa and on cell phone services
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Review charts for coding accuracy and correct coding errors as needed, using ICD (International Classification of Diseases), CPT (Current Procedural Terminology) and HCPC (Healthcare Common Procedure Coding System) codes.
- Review existing billable reports, claim hold queues and any other data available to ensure that coding is accurate and sequenced correctly in accordance with government and insurance regulations.
- Contact physicians and other health care professionals with questions about treatments or diagnostic tests given to patients with regard to coding procedures.
- Follow up with the provider on any documentation that is insufficient or unclear.
- Research for information in cases where the coding is complex or unusual.
- Collaborate with billing department to ensure all bills are satisfied in a timely manner.
- Communicate and work with supervisor and/or IT Helpdesk in order to improve electronic health record functionality and resolve any identified issues.
- Provide feedback, education and training to clinic staff on current coding criteria and guidelines.
- Communicate and work with appropriate staff to correct coding errors in the customized billing system when it affects FQHC and Fee for Service coding.
- Creates quality-training materials and as appropriate tailors them to meet clinic needs (e.g., Diabetes, SBIRT Immunization, etc.).
- Provides communication to supervisors and staff on an ongoing basis regarding quality and accuracy of clinical documentation.
- Continues to develop knowledge and understanding about the history, traditions, values, family systems, and artistic expression of groups served as well as uses appropriate methodological approaches, skills, and techniques that reflect an understanding of culture.
How to Apply