Behavioral Health Coder/Billing Specialist
2 months ago
Fair Haven Community Health Care
FHCHC is a forward-thinking, dynamic, and exciting community health center that provides care for multiple generations at nearly 140,000 office visits in 19 locations. Overseen by a Board of Directors, the majority of whom are patients themselves, we are proud to offer a wide range of primary and specialty care services, as well as evidence-based patient programs to educate patients in healthy lifestyle choices. As we grow and are able to bring high-quality health care to more areas that need access, we continue to put our patients first in everything we do. The mission of FHCHC is “To improve the health and social well-being of the communities we serve through equitable, high quality, patient-centered care that is culturally responsive.”
For over 50 years, we have been a health care leader in our community focused on providing excellent, affordable primary care to all patients, regardless of insurance status or ability to pay. Fair Haven is proud to have a diverse and motivated team of professionals who are constantly seeking ways to enhance and improve the health and well-being of all patients. We believe that everyone should have access to high-quality medical and dental care, regardless of ability to pay.
Job purpose
Fair Haven prides itself on efficient billing services including the filing of claims, appeals processing, and authorizations and, above all, a great passion for helping individuals obtain treatment. The Behavior Health coder/Billing Specialist works with the Billing and Behavior Health departments ensuring all claims are reviewed for accurate documentation, submission and reimbursement
Duties and responsibilities
The Behavior Health Coder/Billing Specialist maintains the professional reimbursement and collections process for the Behavior Health Program. Typical duties include but are not limited to:
- Reviews medical record documentation to determine appropriate ICD-10-CM/CPT codes and modifiers in accordance with official coding guidelines.
- Codes in accordance with coding and departmental guidelines. Maintaining no less than 93% accuracy in choice of codes, as observed in quarterly auditing.
- Prepares by review the submission of clean claims to various insurance companies
- Including but not limited to; carrier, guarantor, place of service and servicing provider
- Work claims and claim denials to ensure maximum reimbursement for services provided
- Uses department resources regularly and follows workflows, with minimal assistance or intervention, to perform daily work to meet daily metrics.
- Works with peers and/or leadership to create and maintain accurate up-to-date policies and procedures.
- Perform other related duties that may be inclusive, but not listed on the job description
Qualifications
- Minimum of a High School Diploma or GED and 1 year of experience in a medical setting.
- A Certified Professional Coding (CPC) certificate through AAPC or other national recognized agency is required or the willingness to get certified within the first 90 days of employment.
- The ideal candidate will have 1-2 years of Behavior Health billing and documentation review experience;
- Federally Qualified Health Centers is helpful.
- The selected candidate will have the ability to work in a team environment or independently; to meet all established deadlines, metrics and assignment goals at all times and have oral and written proficiency in English. Bi-lingual in English and Spanish is highly preferred.
- He/she must be able to use computer and multi-lined telephones;
Direction of Others
None
OSHA Status
Category III—Low Risk Position
Generally works in an office environment with no exposure to bloodborne pathogens
Physical requirements
Physical Demands: Requires walking, bending, sitting, standing, writing, reading, telephone use, data input into computer, pulling medical records, Mental Demands: Ability to cope with continual changing priorities under potentially stressful conditions, Manual Dexterity Required: Ability to use a keyboard, telephone.
American with Disabilities Requirements:
External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job specific responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis.
Fair Haven Community Health Care is an Equal Opportunity Employer. FHCHC does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need.
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