MCPN provides excellent health-related services focusing on the underserved. MCPN has one of the largest population bases of any community health center in Colorado. MCPN is dedicated to being a positive work place with a culturally diverse population of employees that are committed to being focused and disciplined team members. MCPN is also dedicated to taking care of our patients and our employees to ensure the best quality of life.
Performs audits of the documentation and posted CPT, HCPCs and ICD-10 codes of a sample of billed claims to determine whether services ordered by providers are rendered to patients and are accurately billed and supported by the documentation in the clinical medical record. These reviews may be retrospective or concurrent in nature (if concurrent, the bill will not have been submitted to the insurance payer). The auditor will be required to gather data for interpretation and identify unfavorable trends and will facilitate recommendations to improve procedures, strengthen controls, enhance revenue and improve cash flow. The auditor will conduct training as needed to help ensure improved accuracy of billing/coding documentation
- Applies knowledge of CPT and ICD-10 coding guidelines, billing documentation and documentation standards
- Applies knowledge of federal, state and commercial payer billing and payment policies.
- Completes assigned audits of provider and patient care billing.
- Act as the billing and coding expert for the organization
- Provides expertise to billing staff in addressing coding questions, and assists with the appeals for denials for incorrect diagnoses for services performed as needed
- Minimize claims cycle-times, defects and rework .
- Ensure accurate and complete coding daily.
- Provides exceptional customer service to MCPNs providers, clinic operations team, patients and other internal customers.
- Execute daily workload within full compliance of state and federal billing regulations.
- Seeks opportunities to improve billing processes including increased productivity and accuracy.
- Document audit in a clear, concise and consistent manner to support all findings and to enable quality assurance reviews which will help ensure accuracy of the findings and that no other issues exist.
- Prepare written and oral reports on the results of the audits.
- Hold education trainings for billing staff, providers and other clinical staff.
- Meet with providers, clinical and coding staff as identified in the audit compliance plan to educate on identified risk factors from the audit findings.
- Assist the Patient Accounts team with processing charges when needed to meet department monthly and yearly KPI.
- Responsible for reporting any potentially non-compliant conduct.
- Ability to interact positively and build rapport with patients, coworkers and/or external contacts.
- Ability to work independently and organize work in a manner that ensures accuracy and efficiency.
- Ability to analyze and synthesize data to determine the appropriate program.
- Ability to troubleshoot, analyze and problem solve.
- Ability to exercise effective judgment, sensitivity, creativity to changing needs and situations.
- Ability to manage multiple projects to successful completion at a given time.
- Ability to demonstrate the capability to effectively and sensitively respond to the needs and concerns of the full range of MCPN & diverse patient population.
- Ability to handle sensitive information ethically and responsibly.
- Ability to protect the confidentiality of patient, employee and business information.
- Ability to develop educational materials and conduct live one-on-one and/or group training for Patient Accounts staff and Medical Providers.
- Ability to communicate to all staff in a professional manner.
- Motivated self-starter capable of working under minimal supervision.
- Provide exceptional customer service to MCPNs providers, clinic operations team, patients and other internal customers.
- Advanced knowledge of medical terminology, abbreviations, techniques; anatomy and physiology; major disease processes; pharmacology; and the metric system to identify clinical findings, to support existing diagnoses, or substantiate listing additional diagnoses in the medical record.
- Office skills including typing, accounting, 10 key entry, computer terminal usage required
Education or Formal Training:
- High school diploma or GED required
- Certification through AAPC or AHIMA with a coding and auditing credential required:
- Coding Credentials- CPC, CPC-H
- Auditing Credentials- CPMA, CHCA, CHCAS
- 3-5 years of coding experience using ICD-9-CM10, CPT, and HCPCS codes preferred.
Experience: Experience with Centricity and Visualutions a plus
- Experience coding and reviewing patient care documentation for billing purposes.
- Familiarity of interdepartmental interactions as it relates to revenue cycle.
- Community Health Center office experience a plus.
- Medical, Dental, and Optional Vision Insurance.
- Paid-Time-Off (PTO).
- Company Paid Life Insurance.
- A 401K retirement savings plan & match!
- Flexible Spending Account (FSA) and Dependent Care options.
Join Us. Together We Improve lives
MCPN recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our organization. MCPN is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual’s race, creed, color, religion, gender, national origin or ancestry, age, mental or physical disability, sexual orientation, gender identity, genetic information or veteran status. MCPN does not discriminate against any “qualified applicant with a disability” as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization.
Apply Online: https://pm.healthcaresource.com/cs/mcpn#/job/439