Medical Coding Specialist

Medical Coding Specialist

Salary Range $23.22 - $32.78 Hourly

Starting Pay Range: $23.22 - $27.32 per hour

Pueblo Community Health Center offers a flexible benefits program to full-time and part-time employees working 20 hours or more per week. Benefit opportunities presently available to (Full Time, Part Time 20 & 30) employees are listed below:

• Medical Insurance
• Dental Insurance
• Vision Insurance
• Long-Term Disability Insurance
• Short-Term Disability Insurance
• Life Insurance
• 403(b) Tax-Sheltered Annuity Plan
• Cafeteria 125 Flexible Spending Account

In addition to the benefits available for purchase through the Cafeteria 125 plan, Pueblo Community Health Center offers supplemental insurances and generous paid time off benefits including holidays and personal time off (PTO). The organization also contributes to the employee's tax-sheltered annuity plan after one year of service.

Job Summary: Provides documentation review, coding, and data abstracting of medical/behavioral health service documentation to ensure that Pueblo Community Health Center receives appropriate reimbursement and conforms to applicable guidelines and regulations. Accurate and timely coding, abstracting of clinical information which is used for reimbursement purposes, quality improvement efforts and reporting for internal and external purposes. Serves as a technical coding expert. The role is responsible for ICD-10, CPT and HCPC coding of all clinical and hospital service in a timely filing manner with a 95% accuracy rate. The right person for this job will be extremely detail-oriented and accurate. You must have the ability to work independently and communicate effectively with your team.

Reports to: Medical Coding Supervisor

Supervision Exercised: None

Education/Experience/License/Certification:

• High School Degree or equivalent
• AAPC or AHIMA certification preferred
• One year experience with outpatient or inpatient coding using ICD-10, CPT-4, and HCPCS for Medicare, Medicaid and third-party billing required, two years preferred.
• An equivalent combination of education/certification and experience may be substituted.
• Working knowledge of electronic medical record systems preferred.

Required Travel: Infrequent travel may include limited local travel

Knowledge/Skills/Abilities:

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.

1. A working knowledge of OBGYN, podiatry, inpatient, family practice and behavioral health
2. A working knowledge of Local Coverage Determinations, National Coverage Determinations and NCCI guidelines for coding accuracy helpful.
3. Demonstrated ability to understand the clinical content of a health record.
4. Must be able to work with a variety of healthcare professionals at all levels.

Essential Duties and Responsibilities:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Ensure the function and activities of this department to embrace the philosophy, mission, values, and Communicate with Heart service model supported by the Board of Directors of Pueblo Community Health Center, Inc.
2. Adhere to the guidelines and procedures of Pueblo Community Health Center, Inc.
3. Investigates, reviews, and provides clinical and/or coding expertise in the application of medical, behavioral health and reimbursement policies.
4. Communicates with clinical staff to resolve coding issues in a timely manner.
5. Communicates with clinical staff to resolve encounters with no coding attached to ensure timely filing of claims.
6. Corrects and resubmits claims based on review of the medical record.
7. Provides support to clinical staff by answering coding questions and assisting providers in the selection of codes for complex cases and issues.
8. Works with Patient Accounts staff to resolve coding related denials
9. Research problems and answers questions pertaining to coding.
10. Maintains current knowledge of coding conventions, guidelines, updates, and regulations governing government and third-party billing
11. Communicates with the Medical Coding Supervisor to provide feedback regarding documentation issues or reoccurring errors.
12. Must meet and maintain departmental quality and production standards
13. Must maintain all certifications required by this position
14. Participates as needed in testing and training of new or existing systems
15. Perform other related duties as assigned

The above duties are not all inclusive and are not intended to limit or define the duties that may be assigned.

Physical Demands:

The physical demands described here are representative of those that are typically required 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 frequently communicates with employees and the public while performing routine office tasks and must be able to exchange accurate information.
• The employee frequently retrieves and disseminates information using written materials and electronic devices.
• The employee frequently observes, receives, and otherwise obtains information from all relevant sources and identifies information by categorizing, recognizing differences or similarities, and detecting changes in circumstances or events.
• The employee frequently operates computers and other office productivity
• The employee frequently remains in a stationary position while performing routine office tasks.
• The employee frequently moves about the office; and positions self while performing routine office duties such as accessing files and operating equipment.
• The employee frequently moves or positions objects weighing up to 10 pounds while performing routine office duties such as opening file drawers, moving patient files, etc.