Position Summary:

The Certified Professional Coder can demonstrate analytical and problem-solving skills regarding barriers to receiving reimbursement.

Administrative Responsibilities:

• Assign codes to diagnoses and procedures, using ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes for both Behavioral and Medical procedures.
• Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations.
• Search for information in cases where the coding is complex or unusual.
• Receive and review patient medical records and documents for accuracy and to identify all appropriate coding and ensure if the medical records follow the latest reimbursement policies and CMS guidelines.
• Identifies discrepancies, potential quality of care, and billing issues.
• Researches, analyzes, recommends, and facilitates plan of action to correct discrepancies and prevent future coding errors.
• Communicate with insurance companies about coding errors and disputes.
• Coordinate with physicians and behavioral providers with questions about treatments or diagnostics tests given to patients about coding procedures or any documentation that is insufficient or unclear.
• Submit statistical data for analysis and research by clinics.
• Ensure that all codes are current and active.
• Provide training to all behavioral and medical providers on proper coding, documentation, and other regulatory billing requirements.
• Serves as resource and subject matter expert to providers, physicians, and billing team.
• Handles special projects as needed.

Qualifications:

• Associate degree in Medical coding and successful completion of the professional coder certification.
• Strong knowledge of anatomy, physiology, and medical terminology
• Experience (at least 5 years) in substance abuse or behavioral health and primary care services.
• Excellent typing and 10-key speed and accuracy
• Commitment to a high level of customer service
• Superior mathematical skills
• Familiarity with ICD-10 codes and procedures
• Solid oral and written communication skills
• Working knowledge of medical jargon and anatomy preferred
• Able to work independently and taking active part in process and quality improvement initiatives

Physical Requirements

These physical demands are representative of the physical requirements necessary for an employee to successfully perform the essential functions of the job. Reasonable accommodation can be made to enable people with disabilities to perform the described essential functions of the position which are reviewed in each individual case.

While performing the responsibilities of the role the employee is required to talk and hear. The employee is often required to sit and use his or her hands and fingers, to handle or feel. The employee is occasionally required to stand, walk, reach with arms and hands, climb or balance, and to stoop, kneel, crouch or crawl. Vision abilities required by this job include close vision

Benefits

• Vacation, personal, and sick leave
• Medical, dental, vision plans
• Pension & retirement plan
• Short & long-term disability
• Life insurance
• AFLAC
• Pet Insurance

Student Loan Forgiveness Programs

• Public Service Loan Forgiveness
• National Health Service Corp Loan Repayment

Limitations and Disclaimer

The above job description is meant to describe the general nature and level of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties and skills required for the position.