Coder - Casual in St Paul, Minnesota at United Family Medicine

Riverland Community Health is a Federally Qualified Health Center in St. Paul, where patients receive community-based Family Practice medical care in addition to mental health, dentistry, social work and other integrated services. When joining RCH, you become part of a diverse, inclusive, and welcoming team who are dedicated to serving our patients and pursuing our mission to deliver excellent healthcare for all and training for the providers of tomorrow.

JOB SUMMARY:

The Medical Coding Specialist is responsible for the review of medical records, notes, dictation and other related documentation to ensure the accurate and timely submission of charges for professional services provided by physicians and other providers as well as diagnoses for clinic services. The Medical Coding Specialist resolves coding issues as they are identified.

ESSENTIAL FUNCTIONS:

Administrative Duties:

• Review patient medical records, clinician notes, and other documentation in the electronic medical record and/or paper record to determine the appropriate code for diagnosis, procedures, treatments, and encounters in accordance with RCH policies and current ICD-10-CM guidelines.
• Utilize available encoder and other coding resources to determine appropriate CPT code including Evaluation and Management (E&M) codes for professional services.
• Ensure maximum efficiency and reimbursement for properly documented services and work directly with providers to correct unclear or improperly documented encounters.
• Run monthly missing charge report for providers to ensure timely coding and billing.
• Maintain working knowledge of ICD-9/ICD-10, CPT coding requirements and principles, governmental regulations, protocols, third party requirements, and all relevant state and federal billing and documentation guidelines.
• Maintain an understanding and apply knowledge of National Correct Coding Initiatives (NCCI), Local Coverage Documents and National Coverage Documents (LCD/NCD) directives, Medically Unlikely Edits (MUEs), applying knowledge of applicable regulatory requirements and institutional guidelines to select appropriate codes and modifiers.
• Maintain strict confidentiality; adhere to all HIPAA guidelines/regulations.
• Resolve payer denials and respond to inquiries from billing teams, processing corrections as appropriate.
• Navigate software workflows and processes to identify and resolve appropriate electronic rules and create efficiencies.
• Conduct reviews of medical records to ensure compliance with coding and documentation guidelines.
• Follow up with internal customers to facilitate resolution of identified deficiencies in charting.

• Conduct reviews of medical records to ensure compliance with coding and documentation guidelines.
• Follow up with internal customers to facilitate resolution of identified deficiencies in charting.

Perform other tasks as assigned.

KNOWLEDGE, SKILLS AND ABILITIES:

• Advance knowledge of ICD-10 diagnosis coding conventions.
• Knowledge of any Quality Coding Program.
• Expertise on medical terminologies such as abbreviations of diseases, illnesses, and injury processes.
• Strong data entry and computer skills.
• Excellent written and verbal communication abilities.
• Ability to work independently or on a team.
• Skill in identifying problems, problem solving and resolution.
• Ability to analyze patient accounts.
• Demonstrate sound judgement and decision-making abilities.
• Ability to prepare and maintain detailed records, files, reports and other correspondence.
• Ability to establish and maintain effective communication.
• Ability to perform the job in accordance with RCH’s Standards of Business Conduct, which includes compliance, ethics and integrity, confidentiality, protection of assets and avoidance of conflicts of interest and inappropriate business relationships. Specifically, work processes that involve billing/collections practices for avoiding activities that constitute fraud and abuse.
• Excellent time management skills with the ability to prioritize workflow and meet stringent deadlines.

EDUCATION/EXPERIENCE:

• High School Graduate or GED is required.
• Bachelor’s Degree in Health Administration, Health Information Management or other related degrees preferred.
• 1-3-year professional code experience as a Certified Professional Coder (CPC) or Certified Outpatient/Inpatient Code (CIC/COC) or Certified Risk Adjustment Coder (CRC) or Certified Family Practice Coder (CFPC) is preferred.

CERTIFICATES, LICENSES, REGISTRATIONS:

Certified Risk Adjustment Coder (CRC) certification preferred.

PHYSICAL DEMANDS:

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.

WORK ENVIRONMENT:

Work is performed in a clinic office environment. Contact with staff, patients and outside agencies. Possible exposure to communicable disease and medical preparations common to clinic environment.

SUPERVISORY RESPONSIBILITIES:

None

A summary of our benefits include but are not limited to: health, dental, vision, HSA, FSA, basic life insurance, voluntary additional life insurance, spousal and child insurance, long-term disability, and a 403b retirement plan.

In addition, job offers made during flu season are conditioned on the candidate receiving the annual flu vaccination before their start date.

RCH is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.