Medical Billing Coder – Clinica Romero – Los Angeles, CA

Status:
Full-time

*
Schedule: *
40 hours; 8am-5pm Monday-Friday

*
Benefits: *
Medical and Dental
Paid Holidays
Personal Days
Vacation
Sick Leave (10 days per year)
403 B Retirement Plan; 2% employer match after one year of employment
FSA
Life Insurance

*
Position Summary: *
Review medical records utilizing ICD-9 and ICD-10 and CPT coding conventions. Audits medical records to ensure specificity of diagnoses and procedures, and to ensure appropriate and optimal reimbursement from proper payer types.

*
Responsibilities: *

• Analyze medical records and ensure all appropriate International Classification of Disease (ICD-9 & 10) and /or current Procedural Terminology (CPT) coding for billing of proper patient programs.
• Enter and retrieve patient medical data from EPIC-Ochin System updating entries as necessary; audit medical record for accuracy and completeness, note deficiencies and refer for appropriate follow up and completion.
• Consult with physicians and other personnel on coding practices and conventions to provide detailed coding information or gather additional documentation; maintain comprehensive records of all communications regarding suggested changes.
• Research and initiate activity to resolve charges and coding issues, review difficult situations to determine the most appropriate codes.
• Recognize potential for additional coding revenue and initiate the change in the EPIC-Ochin System.
• Enter charges as recorded by back office or clinicians with in a timely manner; charges should be posted with 48 hours of patient visit.
• Post payments to patient’s accounts within a timely period, review all denials and resubmit to correct payer.
• All denials need to be investigated and follow up notes entered into the MIS System of any changes.
• Review and track payments of all submitted billing, reconcile visits and payers records on a weekly basis.
• Assist patients on program eligibility and on billing information.
• Performs various collection actions including contacting patients and payers by phone, correction and resubmitting claims to payers for non –payment.
• Follow’s up on Aging accounts over 90 day’s to determine claim on file, resubmission or denial.

Observes CMOAR Appearance/Dress Standards.

• Observe regulations on time card use and reporting.
• Maintain attendance as a policy.
• Maintain a clean and safe work area.
• Observe general Safety/Employee Health policies and procedures.
• Maintain a current annual health screening.
• Observe CMOAR Appearance/Dress standards.
• Maintain the privacy and confidentiality of both client and employee with regard to medical records.
• Display clearly visible identification
• Treat all patients with respect and dignity and adheres’ to the Patient Bill of Rights.
• Treats all employees with respect and dignity in accordance to non-discriminatory policy and procedure.
• Treat all employees/clients in a courteous and professional manner.
• Conduct only work related conversations when clients are waiting for service.
• Do not discuss other staff members, policies, problems or medical care in public areas of clinic.

Qualifications/Requirements:

• Highs School graduate or equivalent.
• Associate Degree or two years of HIT college level coursework preferred
• Knowledge of Medical Terminology and Anatomy & Physiology required
• Knowledge of Title 22 medical record regulations preferred
• Knowledge of Confidentiality and rules regarding HIPAA and State and Federal governing release of medical information required
• Minimum two (2) years of continuous, relevant ICD/CPT coding experience in an acute care facility within the last five (5) years is required
• System oriented experience in use of computerized medical records abstracting, encoding and database systems
• AAPC American Academy of Professional Coders (CPC)
• Must provide proof of up-to-date COVID-19 vaccinations including recommended doses in the primary series AND booster dose when eligible.

Job Type: Full-time