Job Description
Behavioral Health Coder/Billing Specialist
Job purpose
Fair Haven prides itself on efficient billing services including the filing of claims, appeals processing, and authorizations and, above all, a great passion for helping individuals obtain treatment. The Behavior Health coder/Billing Specialist works with the Billing and Behavior Health departments ensuring all claims are reviewed for accurate documentation, submission and reimbursement Duties and responsibilities
The Behavior Health Coder/Billing Specialist maintains the professional reimbursement and collections process for the Behavior Health Program.
Typical duties include but are not limited to:
Reviews medical record documentation to determine appropriate ICD-10-CM/CPT codes and modifiers in accordance with official coding guidelines.
Codes in accordance with coding and departmental guidelines. Maintaining no less than 93% accuracy in choice of codes, as observed in quarterly auditing.
Prepares by review the submission of clean claims to various insurance companies
Including but not limited to; carrier, guarantor, place of service and servicing provider
Work claims and claim denials to ensure maximum reimbursement for services provided
Uses department resources regularly and follows workflows, with minimal assistance or intervention, to perform daily work to meet daily metrics.
Works with peers and/or leadership to create and maintain accurate up-to-date policies and procedures.
Perform other related duties that may be inclusive, but not listed on the job description
Qualifications
Minimum of a High School Diploma or GED and 1 year of experience in a medical setting.
A Certified Professional Coding (CPC) certificate through AAPC or other national recognized agency is required.
The ideal candidate will have 1-2 years of Behavior Health billing and documentation review experience;
Federally Qualified Health Centers is helpful.
The selected candidate will have the ability to work in a team environment or independently; to meet all established deadlines, metrics and assignment goals at all times and have oral and written proficiency in English. Bi-lingual in English and Spanish is highly preferred.
He/she must be able to use computer and multi-lined telephones;
Direction of Others
None