JobPurpose:The Coding and Auditing Specialist is responsible for reviewing, coding and auditing of documentation for all patient encounters as well as provide training and education to providers and staff. This position also accurately code office procedures for providers to ensure proper reimbursement. This position also reviews coding edits and denials and makes appropriate changes to claim.

Essential Functions:

• Conducts scheduled reviews of provider coding and documentation and prepares reports for leadership.
• Develops training materials on coding and documentation requirements

QualificationsandRequirements:

• High School Diploma or GED equivalent required.
• Coder and Biller Certification required.
• Minimum two to five (2-5) years of experience in a professional medical coding position.
• Minimum one (1) year of auditing experience.

• Knowledge of medical billing, insurance and collection practices required.
• Working knowledge of ICD-10 CPM, CPTs and HCPS guidelines and practices.
• Knowledge of general billing procedures required, FQHC billing preferred.
• Experience with Electronic Medical Records/Electronic Health Records strongly preferred.
• Strong basic arithmetic skills to make calculations, balance and reconcile figures and make changes accurately.
• Able to support the mission, philosophies, goals, and objectives of HealthCore Clinic.
• Have a positive, friendly and professional demeanor with excellent interpersonal skills.
• Assist with gathering data and entering into databases.
• Strong computer literacy, especially with Microsoft Office Suite.
• Strong office skills including accurate typing, data entry, and filing.
• Able to operate office machinery, i.e. copiers, fax machines, multi-line telephone.
• Attention to detail and ability to compose and generate documents and reports.
• Ability to communicate effectively with vulnerable populations including those made vulnerable by their financial status, personality characteristics, place of residence, health status and/or age.
• Able to complete and submit required documentation on time.
• Understand and operate within policy, rules, regulations, and accreditation standards.
• Ability to work productively with internal and external customers.
• Adept at working well with team members.
• Demonstrated positive work ethic.
• Keep supervisor informed about progress and problems.
• Excellent written and verbal communication skills.
• Excellent organizational skills, attention to detail and time management skills.
• Ability to multi-task and organize work effectively while working independently and/or as a cooperative team member.
• Remain flexible to withstand unpredictable changes to workflow and schedules.
• Ability to maintain absolute confidentiality in regards to HealthCore Clinic matters.