Job Description

Overview

Park DuValle Community Health Center is a 501c3 non-profit, federally qualified health center that has served the local community for over 50 years.  Park DuValle Community Health Center strives to adhere to the highest quality standards of patient care, regardless of patients’ insurance status or ability to pay.  Employees of Park DuValle Community Health Center, Inc. are deemed to be federal employees qualified for protection under the Federal Tort Claims Act (FTCA).

Job Skills / Requirements

Position Summary:

Responsible for the evaluation of medical records to claims to ensure completeness, accuracy, and compliance with the International Classification of Disease Manual – Clinical Modification (ICD-CM) and the American Association’s Current Procedural Terminology Manual (CPT).   Assist billing staff and providers with medical claim coding issues/concerns.  Coordinates coding changes with providers and billers and provide technical guidance and training on medical coding to providers and billing staff. 

Primary Position Responsibilities:

• Evaluates medical record documentation and encounter coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflects and supports patient care visits and to ensure that data complies with legal standards and guidelines.
• Interprets medical information such as diseases or symptoms and diagnostic descriptions and procedures to accurately assign and sequence the correct ICD- CM and CPT codes.
• Ensures compliance with government regulations and payer requirements to minimize claim denial.
• Evaluates records and prepares reports on such topics as the number of denied claims or documentation or coding issues for review by Business Office leadership.
• Makes recommendations for changes in policies and procedures. Develops and updates procedures manuals to maintain standards for correct coding, to minimize the risk of fraud and abuse, and to optimize revenue recovery.
• Provides technical guidance to providers and other staff in identifying and resolving issues or errors such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, and/or codes that do not conform to approved coding principles/guidelines.

Supervisory Responsibilities:

• This position has no supervisory responsibilities.

Education Requirements (Any)

High school graduate or Equivalent (GED) and completion of a medical coding certificate program

Certification Requirements (Any)

Possession of Certified Professional Coder (CPC) or equivalent certification

Additional Information / Benefits

Benefits: Medical Insurance, Life Insurance, Dental Insurance, Vision Insurance, Short Term Disability, Long Term Disability, 401K/403b Plan, Paid Time Off (PTO)