Lowell Community Health Center Medical Coder - CPC in Lowell, Massachusetts

Job Responsibilities:

*ESSENTIAL DUTIES AND RESPONSIBILITIES *include the following. Other duties may be assigned.

  1. Organizes and reviews all daily encounters for completeness and accuracy. Tracks any missing encounter forms. Follows-up with site-specific staff on missing data or encounters identified;
  2. Maintains knowledge of fee for service insurance companies, Health Safety Net, Medicaid and Medicare eligible patient billing information to assure accurate billing procedures;
  3. Collect, review, prepare and bill , out of office services;
  4. Consistently updates patient and insurance information to maximize accurate billing activities;
  5. Participates in meetings and reviews of work progress with supervisor and department colleagues;
  6. Interacts with departments to correct information as needed;
  7. Investigate rejected claim to see why denial was issued
  8. Demonstrates respect and confidentiality when processing information related to patient accounts and insurance information;
  9. Edits claims for accuracy before submission to payer;
  10. Evaluate and re-file appeals of patient claims that were denied;
  11. Review charts and provide one-to-one and group educational feedback to the providers;
  12. Consult medial specialist for further clarification and understanding of items on patient charts to avoid any misinterpretations;
  13. Conduct audits and coding reviews to ensure all documentation accurate and precise;
  14. Comply with all legal requirements regarding coding procedures and practices;
  15. Contact providers with questions about treatment or diagnosis test given to patients with regard to coding procedures;
  16. Report missing or incomplete documentation; and,
  17. Serves as resource regarding insurance resolutions and coding questions.

Requirements:

REQUIRED QUALIFICATIONS:

  • High school education or equivalent experience
  • Maintain Certified Physician Coder (CPC) certification
  • 1+ years of professional coding experience
  • Previous facility based coding experience; Experience with OBGYN preferred
  • Previous managed care experience;
  • HCC coding experience;
  • Experience with HEDIS
  • Basic computer skills
  • Basic knowledge of coding guidelines
  • Understanding of medical terminology
  • Manage multiple requests and prioritize appropriately
  • Ability to function in a faced paced setting with a variety of patients and staff
  • Attention to details and prompt follow up

LANGUAGE SKILLS: Bilingual preferred.

PHYSICAL DEMANDS

While performing the duties of this job, the employee is regularly required to sit; reach with hands and arms; and talk or hear. The employee frequently is required to walk. The employee is occasionally required to stand and stoop, kneel, crouch, or crawl and be able to lift up to 20-lbs.

WORK ENVIRONMENT

Job requires physical stamina; many hours/day on the computer terminal. Distracting, busy environment requires ability to focus well in order to do data entry accurately. All staff is expected to cross train and help each other when needed. The noise level in the work environment is usually moderate.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.

Other Job Information (if applicable):

This full-time position is scheduled onsite for 40 hours per week, Monday through Friday

Work Schedule

24 hours per week

Job Code: 2018-9018-003

Department: PATIENT ACCOUNTS

FT/PT Status: F/T (40 hrs/wk), Benefit Eligible

Location: 161 Jackson Street, Lowell, MA