Medical Coder - Billing

MJHS is a large not-for-profit health system in the Greater New York area. Our range of health services include home care, hospice and palliative care for adults and children, rehabilitation and nursing care at Menorah and Isabella Centers, and the research based MJHS Institute for Innovation and Palliative Care. We also offer Elderplan/HomeFirst: health plans for Medicare and dual-eligible individuals. As a not-for-profit organization, many of our programs and services are made possible through the generosity of grateful families, corporate donors and grants, as well as our own employees.
Our MJHS Medical Associates, P.C. is a group of Nurse Practitioners, Physician Assistants, RN Case Managers and LPN's who provide care to Elderplan members who are residents of assisted living and long term care facilities, as well as to those living at home.
Supports medical professional corporation procedural and diagnostic coding of medical records for billing.
Works with professional and non-professional staff for timely record review and ensuring accuracy of medical
documentation and sequencing ensuring that codes meet required legal and insurance rules. Works with internal
and external billing staff to ensure timely and complete billing of claims and encounters. Collaborates and
corresponds with insurance companies and health care professionals to resolve claim denials. Maintains
medical records both electronically and hard copies, maintains productivity and chart metrics. Collaborate with
management staff for process improvement, project work. Performs compliance audits regarding billing,
procedural and diagnostic coding to ensure documentation is accurate and timely. Submits statistical data for
analysis and research by other departments. Able to handle multiple priorities.

Collaborate with health plan leadership and third-party vendor to plan and conduct education initiatives to improve and enhance clinical documentation. Assist in developing and implementing monitoring programs, policies, and procedures of review process. Develop and execute reporting tools for monitoring
Review and complete procedural and diagnostic coding of medical visits and encounters ensuring compliance with current legal standards
Interact with third parties to resolve payment denials and medical record requests
Collaborate with finance to generate revenue cycle reporting on key financial indicators including visit volume, coded, billed, paid, denied, rebilled and write off
Maintains and secures medical records for professional corporation. Makes management aware of issues related to incomplete work and/or problem areas. Accurately prepares medical record documentation for internal and externalaudits
Assist with manager with all departmental initiatives

Associates degree required. Bachelor's degree preferred
Required coding certification (CCS-P or CPC through AHIMA/AAPC)
Requires at lead 1 year of medical record coding and record review experience required
ICD-10 certified, knowledge and experience in CPT codes required
Proficiency with electronic medical records (EMR) or electronic health record (EHR) required
Certified Risk Adjustment Coder (CRC) preferred
Experience working with managed care health organization and outpatient medical practice preferred
Ability to work independently and collaboratively within a team environment to ensure that changes and encounters are posted accurately and timely
Able to multi-task and meet deadlines
Excellent problem-solving skills
Must have excellent interpersonal and communication skills including written, oral and active listening skills
Intermediate Excel, MS Word, Access data entry and report generation
Must have excellent written and oral communication skills, active listening skills
Medical terminology and coding both ICD-9 and ICD-10, CPT required
Experience in internal and external audits required
Knowledge of billing cycle required