Job Description

Certified Professional Coder

Delta Health Center, Inc.is seeking a full-time, detail-oriented, and experienced Certified Professional Coder to join our team.

This role is critical in supporting our physicians and clinical staff to ensure accurate documentation and coding, contributing to the highest quality of patient care.

Position Responsibilities:

• Analyze medical record documentation to ensure accurate assignment of ICD10-CM, CPT, and HCPCS codes, adhering to established coding guidelines and ethical standards.

• Consult with clinical providers for coding and documentation clarification as needed.

• Conduct prospective and retrospective reviews of clinical documentation and coding.

• Provide individual and group feedback to clinical providers, medical staff, and other team members based on coding reviews and identified trends, in alignment with the compliance plan.

• Collaborate with clinical operations and compliance staff to develop and implement corrective action plans for provider documentation issues.

• Develop and revise education and training materials related to documentation and coding.

• Respond to coding questions from providers and staff promptly and accurately.

• Monitor and track coding and coding compliance activities, maintaining detailed records.

• Collaborate with the clinical operations team to address special requests for coding reviews related to patient complaints, denials, rejections, or incorrect coding, and provide feedback to the relevant parties.

• Conduct ongoing reviews and tracking of insurance rejections and denials with coding discrepancies, contacting insurance companies as necessary to resolve issues.

Requirements

Required Skills & Qualifications:

• Proficiency in medical coding, including ICD-10-CM, CPT, and HCPCS coding systems.

• Knowledge and experience in patient eligibility, payer class, insurance type and subscriber requirements for appropriate claim validation and billing submissions required

• Strong analytical skills and attention to detail.

• Excellent communication and interpersonal skills for interacting with providers, staff, and insurance representatives.

• Ability to manage multiple tasks and prioritize effectively.

• Experience with electronic medical records (EMR) systems preferred.

• Familiarity with insurance guidelines and compliance standards.

Education & Experience:

• Certification as an AAPC Certified Professional Coder (CPC or CPC-A) Required

• FQHC Coding and Billing Knowledge Preferred but not required

• High school diploma or GED required; Bachelor’s Degree and/or advanced education or relevant coursework preferred.

• Minimum of 1 year of experience in medical coding

Additional Requirements:

• Must pass a standard background check.

Job Type: Full-time

Benefits

Benefits:

• 401(k)

• 401(k) matching

• Dental insurance

• Health insurance

• Life insurance

• Paid time off (vacation and sick leave)

• Vision insurance

Schedule:

• Monday (8:00 a.m.-6:00 p.m.) and Friday (8:00 a.m.-12:00 p.m.)

License/Certification:

• Certified Professional Coder License (Required)

Work Location: In person/On-site (Required)

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