Job Information

Title: Medical Coder

Summary of Position: With oversight from the Medical Billing and Coding Supervisor, The Medical Coder is responsible for all aspects of medical coding and billing corrections for Kintegra Health ambulatory care services. This includes office, outpatient, and ancillary services. The Medical Coder will understand ICD-9, ICD-10, CPT, and HCPCS coding; have the ability to interpret insurance guidelines relative to medical coding; understand daily balancing techniques; understand abbreviations and medical terminology; have the ability to read a medical chart; and be able to understand the basic components of medical and ancillary procedures.

Experience: Three to five years of billing and coding experience in an outpatient/ambulatory care setting preferred.

Education: AAPC certified

Required Skills: Knowledge of Medical Record content for outpatient visits. Knowledge of medical terminology, anatomy & physiology, DRG and APC assignment, and ICD-10-CM & CPT coding systems. Ability to examine the chart and verify documentation needed for accurate code assignment. Organized and attention to detail and quality. Ability to prioritize workload and strong recall and recognition skills. Ability to perform computer functions in Microsoft Windows. Good verbal, written, and computer communication skills. A valid NC driver’s license with the ability to travel between sites

Additional Skills Suggested: Bilingual preferred but not required

Certifications: AAPC

Key Responsibilities of the Medical Coder

• Review identified coding or billing errors from third party vendor from all Kintegra Health sites and work to correct the errors within 30 days of notice.
• Demonstrate strong analytical skills in order to resolve outstanding insurance claims for all payers
• Review provider documentation to deliver feedback regarding coding appropriately for level of service required and delivered.
• Ensuring documentation compliance with all coding mandates and reporting requirements.
• Retain a working knowledge of the FQHC regulatory quality initiatives to support care team members in performing, documenting, and appropriately coding to meet desired quality benchmarks.
• Evaluate clinical documentation to ensure quality, completeness and consistency regarding code selection and reimbursement.
• Possess thorough knowledge of documentation requirements, unbundling edits, and physician billing issues.
• Possess expertise in guiding billable providers in translating patient information into alphanumeric medical codes suitable for billing, ensuring the facility is reimbursed for all possible procedures.
• Investigate for possible insurance fraud and report any potential fraud to the Corporate Compliance Officer, working with that role to eliminate or mitigate any potential compliance violations.
• Actively reduce AR balances.
• Remain abreast of current best practices for coding and billing and guide in formulating documentation protocols.
• Utilize the AIDET communication model to communicate with customers.
• Actively participate in Quality Improvement Initiatives in your department and in other areas of the department.
• Perform other duties as assigned.

Kintegra Health Core Requirements

• Patient First - An approach to care that holds primary the well-being and desires of the patient.
• Build not Blame - Focusing first on finding fault with the process rather than the person
• Integrity and Honesty - Fostering an acceptance of openness, honesty, and fairness in words, deeds, and the use of organizational resources judiciously for both internal and external customers
• Cooperation and Flexibility - Related to an internal belief that we function as part of an interdependent team with only shared gains or losses, thereby committed to assisting whenever possible beyond the prerequisite job description
• Culturally Sensitive - Always working toward increasing one's ability to understand, communicate with, effectively interact and care for people across cultures while having an acute awareness of one's own culture.

Kintegra Health is a community-sponsored, family-centered provider of health care, health education, and preventive care services without regard to the ability to pay. We screen potential employees first to ensure alignment with our core requirements, followed by the requisite position skill set. In doing so, we need staff committed to this mission who do their best to live and work the characteristics of our core values as we strive to care for ever-increasing members of our communities.

Our goals are:

• To provide continuing comprehensive and accessible primary care services to individuals and families of all economic levels within our counties.
• To provide primary care services to meet individuals' and families' physical and social health needs, promoting health maintenance and providing timely diagnostics, treatment, and referral services.
• To emphasize preventive care through patient and community education to help individuals become aware and responsible for their own health behaviors.
• To employ an interdisciplinary team approach in collaboration with other community providers to provide a continuum of appropriate patient/family-oriented care in a cost-effective manner.