Patient Accounts Coder II (Internal Applicants Only)

Patient Accounts Coder II (Internal Applicants Only)

Summary

Title:Patient Accounts Coder II (Internal Applicants Only)

ID:0603-5079II

Department Location:3205/3207 N. Academy, Colorado Springs, CO 80917

Category:Administrative / Clerical / Skill Trades

Description

Peak Vista Community Health Centers is a nonprofit health care organization whose mission is to provide exceptional health care to people facing access barriers through clinical programs and education. We provide integrated health care services including medical, dental, and behavioral health through our 20 outpatient health centers. We deliver care with our strong "Hospitality" culture. Our organization has over 800 employees and serves more than 74,300 patients annually in the Pikes Peak and East Central regions of Colorado. Our service area covers 14 counties, from the front range to the Kansas border, with locations throughout Colorado Springs, Fountain, Divide, Limon, and Strasburg. Peak Vista is accredited by the Accreditation Association for Ambulatory Health Care, Inc. (AAAHC). Compensation (Pay): $20.18 to $29.26 /hourly based on experience.

Summary of Benefits:

• Medical, Dental, Vision, Life, STD, LTD

• 403(b) Retirement with Company Match

• Paid Time Off

• Tuition Assistance

• Perks Rewards

• Employee Assistance Program

Job Summary: Responsible for understanding the billing requirements for all payors and programs

Essential Duties and Responsibilities include the following.

• Responsible for understanding the billing requirements for all payers

• Enters and approves data into the Management Information system according to appropriate guidelines to ensure that PVCHC accounts receivable is accurate.

• Responsible for coding and entering hospital charges from charge sheets and/or face sheets within established guidelines.

• Analyzes provider documentation to assure the appropriate Evaluation & Management coding levels are assigned the correct CPT or CDT code

• Provides expertise to Billing staff in addressing appeals for denials for incorrect diagnosis’s for services performed.

• Serves on the Patient Accounts Audit team to facilitate the auditing of provider encounters to ensure compliance and maximize reimbursement.

• Serves as coding reviewer to support the charge posting process.

• Executes daily workload within full compliance of state and federal billing regulations.

• Accepts charges, review, analyze, and code diagnostic and procedural information that determines Medicaid, Medicare, CHP+, and private insurance payments.

• The position will require review of ICD-9-CM, ICD-10-CM, CPT, CDT and HCPCS coding for procedures performed by providers.

• CDT and HCPCS coding for procedures performed by providers.

• Conducts periodic Quality Assurance Processes for Patient Accounts Coders to ensure accuracy and policy compliance, in Hospital charges, Coding Review, daily emails, fee tickets and other assigned tasks.

• Tracks and reports the progress of Patient Accounts coders for leadership decision making

• Summarizes and reports the trends of provider documentation and Patient Accounts team production.

• Supports Patient Accounts Coding and Charge Posting Manager in duty assignment and Production Log Review

• Provides initial and ongoing training to provider staff regarding coding compliance.

• Develops training materials for ongoing use by provider staff, and Patient Accounts staff

• Completes charge reconciliation for hospital charges

• Reviews operational processes for improvement opportunities and participates in organizational PI studies, as needed

• Promotes and demonstrates the mission, vision, and Core Values of Peak Vista.

• Develops and maintains good working relationships with all departments, the management team, medical staff, and leadership.

• Embraces cultural diversity amongst ourselves and our community.

• Responsible for the human, financial, and material resources as well as data and information entrusted to us.

• Strives to deliver the best outcomes and highest quality service

• Demonstrates knowledge of and adherence to the Compliance Plan and conflict of interest requirements.

• Enhances the effectiveness, efficiency and productivity of the department by contributing to, and participating in, departmental performance improves goals

• Perform other duties as assigned.

Supervision Exercised : None

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Spanish bilingual preferred.

Education/Experience:

Education: High school diploma or equivalent education.

Work Experience: Coding certification from an approved body, 1-year coding or relevant healthcare experience required, 6 months Peak Vista experience

Computer Skills: Intermediate - ability to access the intra/internet to manage timecard, review policies and procedures, and read company communications; use e-mail to communicate with co-workers, leadership, and other departments; use and create a variety of templates, complex tables, merges; manage table data, sort and filter merges, and also perform basic work with existing Macros; customize toolbars, import and insert graphs, embed Excel data, and elaborate reports; work with multiple worksheets, filter data, use integrate functions, and manipulate databases; customize templates and the PowerPoint environment, and to make a presentation interactive by using hyperlinks and action buttons

Certificates and Licenses: CPC, CPC-P, CCS-P, RHIA or RHIT certification required.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

OSHA risk level/work environmental hazards: This position has been categorized as OSHA Level Three. See Exposure Control Plan for details.

The noise level in the work environment is usually quiet.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The employee must occasionally lift and/or move up to 20 pounds. While performing the duties of this job, the employee is frequently required to sit. The employee is occasionally required to stand and walk.

*Successful candidates will complete pre-employment screening; which includes but is not limited to, a Criminal Background check. Peak Vista Community Health Centers is a drug and alcohol-free workplace and an Equal Opportunity Employer.

**PVCHC participates in the Electronic Employment Verification Program. E-Verify is an Internet-based system that compares information from an employee’s I-9 to data from the U.S. Department of Homeland Security and Social Security Administration Records. To learn more, visit: everify.com