Coder

Shawnee-Christian-Healthcare; Louisville (KY); Hybrid; USD 45,000 - 65,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Life insurance

401K retirement plan

Paid Time Off

Job summary

Shawnee-Christian-Healthcare is seeking a Coder to review, code, and manage reimbursement processes for Medicare, Medicaid, and private payers in Louisville, KY. The role covers coding, charge entry, A/R follow-up, and compliance with coding guidelines and payer policies.

Two years of medical coding experience are required; CPC certification is preferred. Excellent communication, organization, and proficiency with MS Office are essential to succeed in this office-based role with occasional

Qualifications

• Two years’ experience in medical coding required.
• Certified Professional Coder (CPC) preferred.
• Experience in mental health and substance abuse billing preferred.
• Excellent communication skills with patients and staff.
• Self-motivated with strong organizational and interpersonal skills.
• Proficient in MS Word, Excel, PowerPoint, Outlook, Adobe and other office programs.

Responsibilities

• Assigns and sequences codes to diagnoses and procedures from documentation.
• Abstracts information and assigns codes per guidelines.
• Determines final diagnoses and procedures as documented.
• Reviews records for completeness and accuracy of data.
• Ensures compliance with third-party payer rules and regulations.
• Analyzes E/M levels using CPT codes for reimbursement accuracy.
• Collaborates with Clinical Operations to ensure billability of new programs.
• Ensures billable activities align with protocols and regulations.
• Maximizes reimbursement while complying with federal/state rules.
• Acts as a resource for changes in payer Fee Schedules and guidelines.
• Troubleshoots revenue cycle issues and recommends improvements.
• Aligns with SCHC Mission and Core Values.

Skills

Medical coding

Communication

Organization

MS Office

Education

Certified Professional Coder (CPC) preferred

Tools

MS Word

Excel

PowerPoint

Outlook

Adobe

Job description

Louisville, KY, United States of America

The Coder reviews, analyzes, and codes diagnostic and procedural information that determines Medicare, Medicaid and private insurance payments. This role is responsible for coding, charge entry, Accounts Receivable (A/R) follow-up and reimbursement management. This position also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.

Essential Duties and Responsibilities

• Assigns and sequences codes to diagnoses and procedures for documented information. Assures the final diagnoses and operative procedures as stated by the provider are valid and complete. Pulls all necessary information from health records to identify secondary complications and co-morbid conditions
• Abstracts all necessary information and assigns codes, which most accurately describe each documented diagnoses, procedure and special therapy according to established guidelines
• Determines the final diagnoses and procedures stated by the provider are valid and complete
• Performs a comprehensive review for the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered
• Evaluates the record for documentation consistency and adequacy. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established third party reimbursement agencies and special screening criteria
• Analyzes provider documentation to assure the appropriate Evaluation & Management (E & M) levels are assigned using the correct CPT code
• Works with Clinical Operations staff to ensure that any new programs and services are billable
• Ensures all billable activities are consistent with protocols and in compliance with government and payer regulations
• Maximizes reimbursement in a cost-effective manner that is in compliance with federal/state and payer-specific billing requirements
• Serves as a key resource for changes in fee schedule and coding guidelines from all payers
• Troubleshoots, follow through and resolve issues related to the patient revenue cycle; develops and presents recommendations for further consideration by management
• Strong alignment with SCHC Mission and demonstrates behaviors aligned with SCHC Statement of Faith and Core Values
• Other duties as necessary to ensure successful attainment of SCHC goals and objectives

Job Qualifications and Requirements

• Two years’ experience in medical office coding required
• Certified Professional Coder Certificate preferred
• Prior experience working in mental health and substance abuse disorder billing environment preferred
• Excellent communication skills with patients and staff
• Self-motivated with strong organizational and interpersonal skills
• Proficient in computer applications – MS Word, Excel, PowerPoint, Outlook, Adobe and other office-related programs

• Health, Dental, Vision, and Life Insurance
• 401(K) retirement plan with employer matching contributions
• Paid Time Off (vacation and sick)

Working Environment and Physical Requirements

• Work is primarily performed in an office environment but can occasionally be performed remote. Work may be stressful at times. Interaction with others is constant and interruptive.
• Work may require sitting or standing for long periods of time; also stooping, bending and stretching for files and supplies. Occasionally lifting files or paper weighing up to 30 pounds. Requires manual dexterity sufficient to operate a keyboard, and operate office equipment as necessary. Requires normal visual acuity and hearing

Additional Information / Benefits

Benefits: Medical Insurance, Life Insurance, Dental Insurance, Vision Insurance, Paid Vacation, Paid Sick Days, Paid Holidays, 401K/403b Plan

This job reports to the Director of Finance