Coder II

Description

A. POSITION SUMMARY

Supervised by the Medical Behavioral Health Coding and Compliance Auditor, this position will support and provide coding and compliance expertise to the Central Billing team and ensure accurate and ethical coding of claims.

B. ESSENTAIL DUTIES AND RESPONSIBILITIES

· Review provider records and charges, identified by the billers, to ensure compliance with coding and documentation standards.

· Maintain the unbilled report ensuring Provider notes are completed and signed in accordance with FCCH policy timelines.

· Educate staff regarding appropriate coding and/or documentation, inclusive of updates over time;

· Conduct appropriate chart reviews and analyze for over/under coding patterns and appropriate revenue enhancement opportunities.

· Assist with maintenance of the service code master and/or applicable system templates with respect to codes, descriptions, documentation and/or other updates.

Requirements

A. MINIMUM EDUCATION AND EXPERIENCE

· High school diploma or equivalent and CPC certification or equivalent required;

· Minimum of two (2) years in healthcare training and medical service coding experience;

B. KNOWLEDGE, SKILLS AND ABILITIES REQIRED

· Medical terminology;

· Ten-key and keyboarding skills;

· Strong organizational and interpersonal skills including the ability to deliver difficult information positively;

· Extensive knowledge of PC applications including Excel and Word;

· Knowledge of RBRVS and insurance (i.e. Medicare, Medicaid & FQHC) reimbursement regulations;

· Ability to establish rapport and trust in dealing with providers and staff regarding coding issues;

· Demonstrated functional knowledge of CPT, ICD–10, DSM, and HCPCs coding, and ability to maintain current knowledge of changes in these areas;

· Knowledge of and familiarity with compliance programs, and ability to cooperate fully and comply with laws and regulations;

C. PHYSICAL CHARACTERISTICS/WORKING CONDITIONS

A person in this position has sufficient time to complete most tasks although under pressure depending on organization demands. There are frequent opportunities to relax from any physical exertion or to change position in work activities.

1. Physical Effort and Dexterity: Good dexterity to operate personal computer, and basic office equipment. Moderate physical activity expected. Requires handling of average-weight objects up to 25 pounds or standing and/or walking for more than four (4) hours per day.

2. Machines, Tools, Equipment required to be operated: office machines and personal computers for word processing, data entry and retrieval.

3. Visual Acuity, Hearing, and Speaking: Must be able to communicate clearly and accurately for work and safety compliance, including ability to read computer monitors.

Environment/Working Conditions: Work is mostly inside a clinic in a controlled environment. Normal clinic safety precautions and practices are required. Position may require travel throughout the Albuquerque metropolitan area. Work regularly