Medical Coder

Job Details

Pleasanton CA

Full Time

$30.00 - $40.00 Hourly

Description

Company Description :

Axis Community Health a nonprofit established in 1972 provides comprehensive healthcare services to over 15000 individuals across all age groups in the Tri-Valley area. The mission of Axis Community Health isto provide quality affordable accessible and compassionate health care services that promote the well-being of all members of the community.

Our mission is rooted in delivering high-quality patient care encompassing primary healthcare mental health support and dental are committed to ensuring access to essential healthcare services for every member of our community irrespective of financial status living situation or insurance coverage.

Job Summary :

The Medical Coder is responsible for reviewing coding and processing medical dental and behavioral health encounters to ensure accurate and compliant documentation coding and billing specific to a Federally Qualified Health Center (FQHC). This role assigns appropriate ICD-10 CPT and HCPCS Level II codes in accordance with federal state and payer-specific guidelines including FQHC billing rules. The Medical Coder also resolves coding-related denials supports timely reimbursement and helps maintain compliance with Medi-Cal Medicare HRSA and commercial insurance requirements. This position may assist with staff training process improvements and collaboration across billing compliance and clinical teams to ensure accurate encounter data and strengthen revenue cycle operations.

Qualifications :

High school diploma or equivalent; Associates degree in Health Information Technology or related field preferred.

Minimum two years of outpatient medical coding experience preferably in a community health center FQHC or similar ambulatory care setting.

Current coding certification from CPC CCA CCS RHIT or RHIA.

Strong knowledge of ICD-10 CPT HCPCS Level II and outpatient coding guideline.

Familiarity with FQHC specific coding and billing including PPS wrap / PPS add-on and documentation requirements.

Proficiency in reviewing clinical documentation for accuracy and completeness.

Ability to analyze and resolve coding-related denials.

Advanced knowledge of FQHC coding standards encounter-based reimbursement models and HRSA / UDS reporting requirements.

Experience processing specialty billing for chiropractic acupuncture podiatry cardiology and others.

Knowledge of outside entity account reconciliation.

Ability to retrieve patient information input information and locate information and resources.

Knowledge of EPIC EPM / EHR is highly desirable.

Wisdom dental software knowledge is a plus.

Excellent time management skills to meet goals and objectives and the ability to be at work regularly and on time.

Strong analytical employee relations and interpersonal skills.

Excellent writing business communication editing and proofreading skills.

Ability to interact effectively professionally and in a supportive manner with persons of all backgrounds.

Proactive self-motivated and able to work independently as well as on a team with the ability to exercise sound independent judgment.

Ability to maintain a high level of confidentiality and a professional demeanor and must positively represent the organization at all times.

Must be able to adjust priorities quickly as circumstances dictate.

Must be a dynamic self-starter with demonstrated ability to work independently or in a group setting.

A can-do attitude attention to detail ability to organize and set priorities with ability to multi-task effectively.

Ability to type a minimum of 35 WPM with minimal errors.

Must have good computer skills using Microsoft Office and the ability to use Axis departmental systems.

Must be able to use office equipment (i.e. copier fax etc.).

Essential Duties / Responsibilities

Review and assign accurate ICD-10 CPT and HCPCS codes for medical dental and behavioral health encounters.

Ensure all coding complies with federal state Medicaid / Medi-Cal Medicare commercial payer and FQHC-specific billing guidelines.

Verify that provider documentation supports the codes billed and request clarifications when needed.

Review and correct encounter data prior to claim submission to reduce errors and delays.

Work closely with providers to improve documentation accuracy and coding completeness.

Analyze and resolve coding-related denials rejections; submit corrected claims as needed.

Support the billing team with research on payer guidelines and policy updates.

Maintain proficiency in UDS reporting requirements and ensure accurate coding for quality metrics.

Collaborate with senior management to ensure adherence to HRSA PPS and encounter documentation standards.

Conduct internal chart audits as assigned to verify coding accuracy and identify training needs.

Assist in training clinical and billing staff on coding updates documentation requirements and best practices.

Stay current on changes in coding regulations payer updates E / M guidelines and FQHC billing requirements.

Collaborate with the CFO and Billing Manager to enhance workflows aimed at improving overall efficiency and effectiveness of the billing department.

Participate in staff meetings and attend other meetings and training events as assigned.

May be required to perform other related duties responsibilities and special projects as assigned.

Benefits :

Employer paid health dental and vision benefits to the employee.

Option to participate in a 403(B) retirement plan with employer matching contribution.

Partial educational reimbursement.

12paid holidays.

Accrued paid time off with each pay period.

Employee discount programs.

Connect with Axis : Company Page :

Facebook : Gratitude Report : Cognitive and Environmental Working Conditions :

Work is normally performed in a typical clinic office work environment (and in some cases telecommuting sites). The physical demands described here are representative of those that must be met by an employee to perform the essential functions of this job successfully. Reasonable accommodations can be made to enable individuals with disabilities to perform the essential functions of this position if the accommodation request does not cause an undue hardship

Physical : Occasionally required to carry / lift / push / pull / move up to 20lbs. Frequently required to perform moderately difficult manipulative tasks such as typing writing reaching over the shoulder reaching over the head reaching outward sitting walking on various surfaces standing and bending. Occasional travel to other Axis health centers and other occasional travel will be required.

Equipment : Frequently required to use repetitive motion of hands and feet to operate a computer keyboard telephone copier and other office equipment for extended periods.

Sensory : Frequently required to read documents written reports and signage. Must be able to distinguish normal sounds with some background noise as in answering the phone interacting with staff etc. Must be able to speak clearly understand normal communication and be understood.

Cognitive : Must be able to analyze the information being received count accurately concentrate and focus on the given task summarize the information being received accurately interpret written data synthesize information from multiple sources write summaries as needed interpret written or verbal instructions and recognize social or professional behavioral cues.

Environmental Conditions : Frequent exposure to varied office (medical clinic / office) environments. Rare exposure to dust and loud noises.

Disclaimer : This job post is not necessarily an exhaustive list of all essential responsibilities skills tasks or requirements associated with this position. While this is intended to be an accurate reflection of the position posted Axis Community Health reserves the right to modify or change the requirements of the job based on business necessity.

Key Search Words : Medical Coder Billing and Coding Specialist Health Information Coder Clinical Coder Coding Specialist Revenue Cycle Coder Coding Compliance Specialist Outpatient Coder Documentation Specialist Revenue Cycle Department Patient Financial Services Coding and Compliance Billing and Coding Team Communication Skills Multitasking Problem Solving Organizational Skills Customer Relations Administrative Procedures Microsoft Office EHR EPIC Medi-Cal Medicare #LI-Onsite

Key Skills

Collection And Recovery,Banking,ABAP,Insulation,Investment Management,Client Services

Employment Type : Full-Time

Experience : years

Vacancy : 1

Hourly Salary Salary : 30 - 40