Located in the heart of the Coachella Valley, you have access to resort-style living and world-class amenities throughout Southern California.
Job Objective:
Reviews E&M and simple visit charges submitted by providers in assigned work queue(s) to validate level of service, place of service, new verses established, and modifier review to ensure valid creation of claim. Reviews and enters manual charges submitted by providers for external services. Reviews and resolves simple NCCI, LCD and MUE edits.
Job Description:
Education:
Required: High school diploma, GED or higher level degree Preferred: Enrolled in a coding certification program or holding an Apprentice Certificate in coding- CPC or CCS; courses in Medical Terminology, Anatomy and PhysiologyRequired: High school diploma, GED or higher level degree
Preferred: Enrolled in a coding certification program or holding an Apprentice Certificate in coding- CPC or CCS; courses in Medical Terminology, Anatomy and Physiology Licensure/Certification: Required: Within eighteen (18) months of hire complete a coding certification program: CPC-A, CPC, CSC or RHIT
Licensure/Certification:
Required: Within eighteen (18) months of hire complete a coding certification program: CPC-A, CPC, CSC or RHIT
Experience:
Preferred: Enrolled in a coding certification program or holding an Apprentice Certificate in coding- CPC or CCS; courses in Medical Terminology, Anatomy and Physiology Licensure/Certification: Required: Within eighteen (18) months of hire complete a coding certification program: CPC-A, CPC, CSC or RHIT Experience: Required: One (1) year of experience in billing/charge capture coding or related services
Essential Responsibilities:
- Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
- Maintains quality of work based on current published standards.
- Reviews documentation and sequences diagnoses and procedures using current coding guidelines for E&M and simple visit encounters.
- Completes claim information and validates for split or non-split payers.
- Communicates with Coder IIs, department management and clinic staff to obtain needed documentation to ensure correct billing.
- Completes assigned work queue assignments within departmental productivity standards.
- Obtains and maintains a
- Maintains a thorough understanding of anatomy and physiology, medical terminology, disease processes through participation in continuing education programs to effectively apply ICD-
Essential Skils:
- Knowledge of general CMS guidelines and general billing guidelines
- Written and verbal communication skills
- Ability to use Microsoft Office Suite (Word, Excel, Outlook, PowerPoint) and other relevant software applications
- Knowledge of ICD-10-CM & CPT/HCPCS coding conventions
- Knowledge of medical terminology, anatomy and physiology
- Coding software familiarity
- Knowledge of Denial and appeals process
