Certified Medical Coder

Job Description

All About Hamilton Health Center

Hamilton Health Center (Hamilton), established in 1969, is a Federally Qualified Health Center (FQHC) located in Harrisburg, PA. The center continues to grow by taking a holistic and comprehensive approach to patient-centered care. Our mission is to improve the health of Central Pennsylvania’s residents by delivering high-quality, respectful, and patient-centered health and related social services that promote access, treatment, education, and prevention, regardless of health, economic, or insurance status. Our vision is to be the premier community health clinic of the underinsured and uninsured to include medical, dental, social, and related services and to become a healthcare provider of choice for the Greater Harrisburg area residents. For over 50 years, we have been true to these words. As part of our team, you will work alongside dedicated professionals who care deeply about the individuals we serve.

Benefits Offered: In addition to your base salary, you are also eligible to receive:

Generous paid time off

Birthday holiday and 7 paid holidays

Medical, Dental & Vision Coverage

Company-paid life insurance.

Retirement Plan with matching opportunity

Employee Assistance Program

Job Summary:

Performing technical and specialized functions for HHC, the incumbent reviews, analyzes, and codes diagnostic and procedural information that determines Medicare, Medicaid, and private insurance payments. The primary function of this position is to perform ICD-9-CM, CPT, and HCPCS coding for reimbursement. The coding function ensures compliance with established coding guidelines, third-party reimbursement policies, regulations, and accreditation guidelines.

Essential Duties and Responsibilities:

Assigns and sequences ICD-10-CM/CPT/HCPCS codes to diagnoses and procedures for documented information, assures the final diagnoses and operative procedures, as stated by the provider, are valid and complete. May abstract necessary information from health records to identify secondary complications and co-morbid conditions, determining the final diagnoses and procedures stated by the provider or other health care provider are valid and complete.

Quantitative analysis – Performs a comprehensive review of 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.

Qualitative analysis – 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 providers and staff to develop appropriate templates and protocols to support the adoption of appropriate clinical documentation policies and procedures.

Conducts in-depth assessments of clinical processes and workflow, providing oversight of the clinical process, workflow design, and implementation, working with front office staff.

Identifies user needs, designs instructional material, and conducts training sessions.

Performs all duties according to established safety procedures, clinic policy, and other fiscal department duties as assigned.

Required Knowledge and Skills:

Incumbent must have advanced knowledge of medical terminology, abbreviations, techniques, and medical procedures; anatomy and physiology; major disease processes; pharmacology; and the metric system to identify specific clinical findings, to support existing diagnoses, or substantiate listing additional diagnoses in the medical record. Must have knowledge of medical codes involving selections of the most accurate and descriptive code using the ICD-10-CM, Columns 1-3, CPT, HCPCS, and the HIS coding conventions, as well as advanced knowledge of medical codes involving selection of the most accurate and descriptive code using the CPT codes for billing of third-party resources. Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes. Must have excellent disposition and ability to communicate effectively and establish and maintain harmonious, productive working relationships with Providers, department heads, managers, and customer base.

Minimum Qualifications:

Must be a Certified Coder, with at least three years of related experience and/or training; or an equivalent combination of education and experience directly related to coding analysis in a medical setting, FQHC experience preferred.

This job description provides an overview of the duties associated with the position and should not be interpreted as a complete list of all responsibilities. All candidates, including current employees, selected for the position will undergo a background check that is appropriate for the responsibilities of the role.

EOE

Full-time