Purpose of Job:
Improve the overall health of the communities we serve by ensuring accurate documentation and coding as follows:
Essential Duties and Responsibilities:
• Coaches and develops the coding team to establish a culture of quality assurance, teamwork and excellent customer service.
• Serves as the subject matter expert in FQHC billing, including being responsible for researching new or changing requirements related to documentation, coding and billing practices.
• Identifies and communicates industry-specific trends and changes in regulations to key stakeholders.
• Develops and maintains coding and billing operating guidelines.
• Develops training resources for Providers and Coders to ensure documentation supports coding for risk gaps, social determinants of health and performance and/or quality measures.
• Develops and maintains audit processes to ensure complete documentation, coding accuracy and appropriate reimbursement.
• Performs other duties as assigned.
Qualifications:
Education/Experience: Two-year degree required. Bachelor’s Degree preferred. Certified Professional Coder certification required. Minimum of five years billing experience required. Supervisory experience required. Experience working in a Federally Qualified Health Center (FQHC) preferred.
Skills: Working knowledge of CPT, HCPCS, and ICD10 coding required. HCC coding preferred. Understanding of third-party payers operating procedures and practices required. Understanding of Federal, State, and Local legal, compliance & regulatory provisions related to billing practices in a medical office required. Superior communication and interpersonal skills required. High level of motivation and initiative to accomplish goals required. Computer skills required. Organizational skills and attention to detail required. Knowledge of appropriate HIPPA regulations required. Valid drivers’ license and insurance required.
Physical Demands:
While performing the duties of this job, the employee is regularly required to talk, hear and sit. The employee is occasionally required to move around the facility; use hands to finger, handle, or feel; reach with hands and arms; climb or balance and stoop, kneel, crouch, or crawl. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 lbs.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.