Coding And Billing Specialist

Summary

Join firsthand as a Coding & Billing Specialist and become a key member of our clinical documentation team. You will be responsible for reviewing daily encounter coding, handling coding queries and corrections, submitting claims, and educating team members on proper coding procedures. This role requires 4+ years of experience as a medical billing and coding specialist using an EHR system, proficiency in ICD-10-CM and CPT coding, and relevant certifications. You will leverage your expertise in medical terminology and communication skills to ensure accurate billing and documentation. This is a fulfilling opportunity to make a real difference in the lives of individuals with serious mental illness, while enjoying a supportive and inclusive work environment with competitive benefits.

Requirements

• Have 4+ years experience as a medical billing and coding specialist leveraging an Electronic Health Record (EHR) system
• Are able to gain proficiency in firsthand EHR, Clearinghouse, and other billing software systems
• Have a strong knowledge of ICD-10-CM and CPT coding guidelines; medical terminology; state and federal Medicare reimbursement guidelines; English grammar and usage
• Are proficient in medical terminology: ability to read and interpret medical procedures and terminology
• Have excellent written and verbal communication skills, especially to maintain working relationships with firsthand APNs, NPs, Clinical Documentation Integrity Specialist, and other team members
• Have strong multi-tasking skills and consistent attention to detail
• Support firsthand’s mission, vision and values: Demonstrates respect, dignity, empathy, and professional conduct to both individuals that firsthand serves and firsthand team members
• A High School diploma or equivalent
• Medical coder certification, such as: Certified Professional Coder (CPC) from AAPC (American Academy of Professional Coders)Certified Coding Specialist (CCS) from AHIMA (American Health Information Management Association)

Responsibilities

• Appropriately codes services, procedures, diagnoses, and treatments
• Verifies that the assignment of International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and Healthcare Common Procedural Coding (HCPC) codes are compatible, appropriate, and accurate for billing
• Use medical terminology to understand clinical documentation and determine if it appropriately supports diagnoses
• Reviews all individual visit encounters for completeness and accuracy in all services rendered
• Educates firsthand Advance Practice Nurses (APNs), Nurse Practitioners (NPs), and other team members on proper code selection, documentation, procedures, and requirements
• Provides technical guidance to APNs, NPs, and other team members in identifying and resolving issues or errors such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, and/or codes that do not conform to approved coding principles/guidelines
• Prepares and submits claims for payment, and corrects rejected claims

Preferred Qualifications

Certified Risk Adjustment Coder (CRC) certification from AAPC

Benefits

• For full-time employees, our compensation package includes base, equity (or special incentive program for clinical roles) and performance bonus potential
• Our benefits include physical and mental health, dental, vision, 401(k) with a match, 16 weeks parental leave for either parent, flexible vacation, and a supportive and inclusive culture