Certified Medical Coder

2 days ago

Commerce, United States JWCH Institute Full time
Position Purpose:

The Certified Medical Coder plays a crucial role in the Billing Department by ensuring precise and compliant coding of medical services. Under the guidance of the Billing Department Supervisor, the Coder will assign appropriate diagnosis and procedural codes for services provided by JWCH physicians, adhering to industry standards and legal requirements. This position involves validating and auditing coding practices to guarantee accuracy in billing, supporting optimal reimbursement, and maintaining adherence to regulatory guidelines.

Duties and Responsibilities:
  1. Serve as the primary liaison between providers and the Billing Department, effectively communicating to clarify diagnoses, procedures, coding, and documentation requirements.
  2. Recommend appropriate ICD-10-CM, CDT diagnosis codes, CPT codes, and HCPCS codes.
  3. Regularly review diagnosis and procedure coding within NextGen to ensure optimal billing accuracy.
  4. Collaborate with clinicians on the correct use of ICD-10 codes to enhance HEDIS, HCC, and other performance incentives submitted through claims data.
  5. Work with the Quality Insurance Team to ensure coding supports Meaningful Use and other clinical incentive payments.
  6. Provide compliance and coding training to new providers during onboarding and orientation.
  7. Ensure all codes are current and active.
  8. Code based on documentation in the medical record.
  9. Report missing or incomplete documentation.
  10. Evaluate and ensure that all codes are submitted to third-party payers and IPA.
  11. Act as a resource for insurance resolutions and coding questions.
  12. Follow coding guidelines and legal requirements to ensure compliance with federal and state regulations.
  13. Support the Billing Supervisor in improving current medical billing practices.
  14. Conduct monthly coding audits and maintain up-to-date outcome reports.
  15. Perform other duties as assigned.
Qualifications:
  1. High School diploma or GED.
  2. Medical Coding Certificate; RHIT or CPC certification from AAPC or AHIMA; meet state licensure requirements.
  3. Maintain coding certification and attend in-service training as required.
  4. Two years of medical coding experience.
  5. Understanding of medical terminology, anatomy, and physiology.
  6. Ability to work independently or as part of a team.
  7. Strong computer skills in data entry, coding, and knowledge of Electronic Medical Record software; proficiency in Microsoft Office Suite.
  8. Exceptional attention to detail.
  9. Ability to multitask, prioritize, and manage time efficiently.
  10. Excellent verbal and written communication skills.
Preferred:
  1. Bachelor's degree in a related field.

*All JWCH, Wesley Health Centers workforce are recommended to be fully vaccinated and boosted against COVID-19.

Employee Benefits:

JWCH Institute, Inc., offers competitive salaries for all positions. Employees working 30 hours per week or more are provided a monthly allowance which can be used towards medical, dental, and vision premiums. The agency offers sick leave, vacation time, 13 paid holidays, 401(k) Safe Harbor Profit Sharing plan, mileage reimbursement, short term and long tern disability plans, life insurance policies, employee parking and more

Wesley Health Centers JWCH Institute is an Equal Opportunity Employer

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