Coder II

For more than 50 years, First Choice Community Healthcare has provided access to high quality primary medical, dental, and behavioral healthcare to the underserved populations of the Mid-Rio Grande Valley of central New Mexico. Today, we operate seven (7) Community Health Centers and one (1) school-based clinic. We are currently recruiting for a Coder II to join our team and assist in fulfilling our organizations mission, which is to improve the health, life skills and wellbeing of all members of the communities we serve. Our health centers maintain an open-door policy, providing treatment regardless of an individual’s income or insurance coverage. As a non-profit organization, First Choice is a vital community resource in Central New Mexico. Not only does our organization provide the highest quality, comprehensive medical services, but we also address our patients’ emotional, social, and cultural needs.

• Medical Insurance
• Dental Insurance
• Vision Insurance
• Flexible Spending Account
• Employee Assistance Program
• Aflac
• Life and AD&D Insurance
• Voluntary Life Insurance
• Identity Theft
• Retirement Savings -403(b)
• 10-20 days per service year (based on length of service)
• Sick Leave 64 hours per year (unused rolls over each year into Long Term Sick Leave)
• Long Term Sick Leave 40 hours per year
• 10 Paid holidays per year
• 40 hours of Educational Leave per year for full time employees
• $700 per year for tuition reimbursement

A. POSITION SUMMARY

Supervised by the Medical Behavioral Health Coding and Compliance Auditor, this position will support and provide coding and compliance expertise to the Central Billing team and ensure accurate and ethical coding of claims.

B. ESSENTAIL DUTIES AND RESPONSIBILITIES

· Review provider records and charges, identified by the billers, to ensure compliance with coding and documentation standards.

· Maintain the unbilled report ensuring Provider notes are completed and signed in accordance with FCCH policy timelines.

· Educate staff regarding appropriate coding and/or documentation, inclusive of updates over time;

· Conduct appropriate chart reviews and analyze for over/under coding patterns and appropriate revenue enhancement opportunities.

· Assist with maintenance of the service code master and/or applicable system templates with respect to codes, descriptions, documentation and/or other updates.

· Participate in special audits, as assigned;

· Work as a team member with all applicable staff members and offices;

· Perform other duties, as assigned.

A. MINIMUM EDUCATION AND EXPERIENCE

· High school diploma or equivalent and CPC certification or equivalent required;

· Minimum of two (2) years in healthcare training and medical service coding experience;

B. KNOWLEDGE, SKILLS AND ABILITIES REQIRED

· Medical terminology;

· Ten-key and keyboarding skills;

· Strong organizational and interpersonal skills including the ability to deliver difficult information positively;

· Extensive knowledge of PC applications including Excel and Word;

· Knowledge of RBRVS and insurance (i.e. Medicare, Medicaid & FQHC) reimbursement regulations;

· Ability to establish rapport and trust in dealing with providers and staff regarding coding issues;

· Demonstrated functional knowledge of CPT, ICD–10, DSM, and HCPCs coding, and ability to maintain current knowledge of changes in these areas;

· Knowledge of and familiarity with compliance programs, and ability to cooperate fully and comply with laws and regulations.