Medical Billing Coder

at Katahdin Valley Health Center in Dover Foxcroft, Maine, United States

Job Description

Katahdin Valley Health Center
Job Description
Billing Coder

Reports To: Billing Manager
Status: Hourly
Facility Location: Varies
Hours: Monday-Friday 8:00AM-5:00 PM

POSITION SUMMARY
The Certified Professional Coder will be responsible for review and submission of claims from all KVHC patient visits. This person will be responsible for Provider Education and Chart Audit in regards to coding. The CPC will work as part of the Patient Care Team to ensure effective and quality care is given to the KVHC patient.

RESPONSIBILITIES
1. Check/correct or assign codes for each visit as indicated per office notes and provider’s orders.
2. Review and analyze documentation for services in order to be compliant with ICD-10-CM and CPT guidelines.
3. Review charge slips to maximize charges for each visit
4. Post charges into Athena.
5. Resolve any coding related billing issues.
6. Perform coding and CPT utilization audits.
7. Stay current and adhere to rules and regulations concerning Medicaid, Medicare, and private insurance
8. Work directly with the Billing Representatives.
9. Communicate with providers to resolve documentation needs as they arise
10. Provide coding education to providers at provider meetings
11. Keep current on certification for Professional Coder
12. Attend trainings as required and responsible for obtaining and maintaining personal CPC certification.
13. Become proficient with Practice Management Systems (Athena Health)
14. Perform Chart Audits on an as needed basis.
15. Adhere to patient confidentiality requirements to include but not limited to the guidelines of the Health Insurance Portability and Accountability Act.
16. Performs additional duties or projects as assigned by the Chief Financial Officer.
17. Adheres to all KVHC policies and protocols.
18. Complies with all safety rules and protocols. Reports all incidents, regardless of severity, immediately to their supervisor and completes an incident report and investigation form, which will be forwarded to Human Resources within 24 hours of the incident.
19. Conducts themselves as a good steward in the communities served by KVHC; represents the organization at outreach activities as needed.
20. Actively participates as committee member as assigned by the Chief Executive Officer.
21. Interacts harmoniously and effectively with others. Focusing on the attainment of organization goals and objectives through a commitment to team work.
22. Conforms to acceptable attendance and punctuality standards as expressed in the employee handbook.
23. Abides by the organization’s compliance program and requirements
24. At times you may be faced with challenges that may impact patient care. Addressing these challenges may not be in your job description, however Katahdin Valley Health Center encourages each team member to go above and beyond to address the patients’ needs in the moment. Employees have the autonomy to see the care experience through from A to Z to show our patients KVHC C.A.R.E.S.

PROFESSIONAL EXPECTATIONS
1. Admit mistakes or missteps openly, own your own behavior, forgive one another, and model vulnerability and humility.
2. Keep discussions about team members, subordinates, and colleagues as well as challenges in the workplace, positive, constructive, and factual.
3. Be mindful of employee confidentiality even among peers, and particularly where an issue involves a peer.
4. Only say what you would be willing to say to someone directly.
5. Whenever possible, speak directly to the person with whom you are having a disagreement or a challenge. Challenge yourself to engage in these discussions. Do not avoid constructive conflict.
6. Work with your supervisor or HR when you need to process a performance or behavioral situation with a colleague or subordinate to determine next steps.
7. It is always okay, and usually preferable, to pause, and take time to reflect before reacting to a situation.

EDUCATION AND EXPERIENCE
1. High School Diploma or GED, or a combination of education and experience.
2. Certification as a Professional Coder.
3. Completion of Anatomy & Physiology, and Medical Terminology Courses.
4. Experience in Medical Billing and Coding.
5. Strong Computer Skills.
6. Ability and education to perform coding and CPT Utilization Audits.
7. Ability to work well with co-workers, clients and providers.
8. Flexible schedule in order to attend evening provider meetings.
9. Data Entry experience.
10. Strong written and verbal communication skills.
11. Must possess a clean criminal and DHHS background.
12. Must possess the ability and means to travel between clinics as needed.
13. Valid State of Maine Driver’s license and ability to be insured by KVHC’s vehicle insurance carrier.

FUNCTION, DEMANDS AND PHYSICAL PERFORMANCE
Requires full range of body motion with the ability to bend, kneel and stoop. Must possess: the ability to sit and or stand for long periods of time, the ability to lift approximately 30 lbs., visual acuity with color vision, the ability to communicate effectively and calmly in a professional manner, the ability to follow all workplace policies including safety and confidentiality, the ability to perform repetitive motion keyboarding functions, exposure to communicable disease, toxic substances, medicinal preparations and other conditions common to clinic environment. Knowledge of organizational policies, regulations, and procedures to administer patient care. Must possess the ability to work with and around medical equipment and instruments safely and effectively as appropriate. Knowledge of common safety hazards and precautions to establish a safe work environment including Safety Data Sheets. Skill in preparing and maintaining records, writing reports, and responding to correspondence. Skill in developing and maintaining department quality assurance. Skill in establishing and maintaining effective working relationships with patients, medical staff, and the public. Ability to maintain quality control standards. Ability to react calmly and effectively in emergencies. Ability to interpret, adapt and apply guidelines and procedures. Ability to communicate clearly.

CONFIDENTIALITY OF PATIENT INFORMATION AND ALL KVHC HEALTH CENTER BUSINESS IS ESSENTIAL. EMPLOYEES MUST COMPLY WITH THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996-PUBLIC LAW 104-191