Job Summary:
The position of Certified Medical Coder at Gloria Nelson Center (GNC Family Clinic) plays a pivotal role in the revenue cycle. This individual holds the responsibility of accurately coding, auditing, adjusting, adding diagnosis codes, and processing claims for all payers. Moreover, they are tasked with ensuring the timely completion of reports following established protocols.
Job Duties:
· Codes and abstracts routine to complex patient medical record information according to ICD and CPT systems; adheres to coding conventions and guidelines established by the AMA, CMS, and all payers.
· Participates in Quality Improvement activities and training programs as necessary.
· Collaborates with the Billing department to ensure accurate and timely billing processes.
· Reviews medical record documentation verifies coding and DRG assignments in response to billing requests, and corrects any errors as needed.
· Provides training to medical staff on proper charting and coding procedures.
· Reviews and processes subpoenas according to policy or deadlines, and scans documents as directed.
· Maintains flexibility to change work shifts to meet patient and department needs.
· Establishes and maintains positive working relationships with patients, payers, team members, and stakeholders.
· Ensures confidentiality of patient information in compliance with HIPAA regulations.
· Assists in compiling statistical data for clinic reporting.
· Undertakes other projects related to billing, data entry, and computer operations when required.
· Ensures accurate documentation and coding on Fee-Tickets/Charge Slips and EMR for proper billing claims.
· Reads and interprets patient medical information, applies correct ICD-9, ICD-10, CPT, and HCPCS codes for accuracy, and corrects any coding errors.
· Research documentation with medical personnel to clarify information when necessary.
· Posts charges for various facilities and providers to ensure accurate coding and patient accounts, following up with providers for complete file compilation for billing accuracy.
· Reviews bundled procedures and applied modifiers for higher insurance payments based on medical record documentation.
· Submits claims with correct coding for maximum payments from various insurance providers daily or as instructed by the Billing Manager.
· Communicates regularly with the Clinic Director, Front Office Staff, Clinical Coordinators/Staff, and Providers to ensure completion and submission of route slips and documentation according to established guidelines.
· Performs any other related duties as directed by the Billing Manager/Clinic Director.
Required Skills/Abilities:
· Ability to thrive in high-pressure environments.
· Proficient in managing multiple functions simultaneously.
· Understanding of community-based organizations and their dynamics.
· Excellent communication skills (verbal, nonverbal, written) essential for effective interaction with medical staff, Office Managers, Billing Department, and Directors.
· Demonstrates prompt and efficient work capabilities.
· Strong problem-solving skills aligned with organizational policies and procedures for decision-making.
· Capable of working autonomously, showing initiative, follow-through, and organizational proficiency.
· Thorough knowledge of all payer codes.
· Familiarity with all programs offered by GNC.
· Fully embraces and advocates GNC's mission statement.
· Ability to engage with the public regardless of ethnicity, religion, or economic background.
· HIPAA Compliance: Ensures up-to-date compliance with all HIPAA regulations, treating member information with the utmost confidentiality.
· Compliance: Upholds adherence to local, state, and federal regulations.
· Quality Assurance/Quality Improvement: Actively participates in QA/QI activities to enhance organizational performance.
· IT Proficiency: Required to learn and utilize Electronic Health Records and Practice Electronic System tools such as NextGen, M365, etc., as outlined in the Policies and Procedures.
Qualifications, Education, and Experience:
· High school diploma or GED accompanied by at least two years of hands-on experience managing billing and accounts receivables in a similar environment or relevant field.
· Certification as CPC, CPB, COC, or NCICS with a minimum of 2 years of coding expertise.
· Demonstrates consistent maintenance of Coding Certification Credentials.
· Proficient understanding of coding regulations, rules, and third-party payer specifications.
· Possesses strong customer service aptitude and professional demeanor for effective communication with staff, management, providers, and patients.
Classification: Full-Time Position
Schedule:
Monday through Friday 8:00 am -5:00 pm
Some Overtime may be required.
Salary:
$20 - $27 hourly
Physical requirements:
· Bending/Twisting 1%
· Stooping 5%
· Walking 20%
· Sitting 46%
· Push/Pulling N/A
· Reaching Overhead 2%
· Driving 10%
· Standing 5%
· Kneeling/Crawling N/A
· Repetitive Motion 40% (keyboard)
· Must be able to lift up to 15 lbs.
Why join our team?
Gloria Nelson Center, known as GNC Family Clinic, stands as a beacon of healthcare excellence within the rural landscape. Our distinguished establishment offers a diverse range of specialized medical services in Family Practice, Pediatrics & Obstetrics, and Gynecology to the vibrant communities of Delano, Rich grove, McFarland, Wasco, and Earlimart. Nestled within our state-of-the-art facility, GNC Family Clinic boasts a longstanding legacy of delivering superior patient care, firmly rooted in a commitment to quality and compassion.
North Kern South Tulare Hospital District is an equal opportunity employer and strives to attract qualified applicants from all walks of life without regard to race, color, ethnicity, religion, national origin, age, sex, sexual orientation, gender identity, gender expression, marital status, ancestry, physical disability, mental disability, medical condition, genetic information, military and veteran status, or any other status protected under federal, state and/or local law. We aim to create an environment that celebrates and embraces the diversity of our workforce.
We welcome you to join our team!
Job Type: Full-time
Pay: $20.00 - $27.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Ability to Relocate:
- Delano, CA 93215: Relocate before starting work (Required)
Work Location: In person