Position Summary: Abstracts clinical information from a variety of medical records, charts and documents and assigns appropriate ICD-10 and/or CPT codes to patient records according to established procedures. Ensures record accuracy, follows up, and makes necessary revisions. Follows proper medical and insurance claim processes.
Essential Job Functions:
- Review and enter medical, dental, and mental health claims and hospital charges.
- Apply ICD-10, CPT codes, and modifiers for billing
- Perform posting charges
- Perform completion of claims to payers
- Conduct duties in a professional and timely fashion
- Submit billing data to the appropriate insurance providers
- Process claims
- Resolve denial instances
- Achieve maximum reimbursement for services provided
- Deploy, maintain and report on various programs
- Do Medicare and Medicaid reviews
- Do Medi-Cal reviews
- Conduct audits
- Verify appropriate documentation of procedures, ensuring correct billing of lab tests, and review surgical procedures to assign appropriate codes for billing.
- Post insurance payments.
- Follow up with insurance denials as needed.
- Research and audit for missing charges.
- Assist with patient and staff billing questions and concerns.
- Perform other duties as assigned by Supervisor.
Skills & Qualifications:
- Medical and/dental coding and billing experience required
- Prior experience with Vermont Medicaid billing preferred
- Prior experience in a Federally Qualified Health Center preferred but not necessary
- Demonstrated mathematical skills and high attention to detail necessary
- Ability to work in a fast pace highly productive environment
- Strong computer skills, including proficiency with EMR systems, Outlook, and Excel
- Excellent interpersonal, teamwork and organizational skills
Working Environment:
This job operates in an office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. This is a largely sedentary role; however, some filing is required. This would require the ability to sit for extended period using a computer to perform data entry and reviews.
Education, Licensure & Experience:
Certified Professional Coder (CPC) certification preferred.
ABOUT US:
The Health Center is a Federally Qualified Health Center (FQHC), dedicated to providing quality health care for individuals and families, regardless of ability to pay. The Health Center offers a full range of on-site medical, dental, behavioral health, nutrition, pharmacy and neurology services, with an emphasis on prevention and patient education, all provided with skill, caring, and compassion. In addition to traditional dental services, The Health Center offers oral surgery, hospital dentistry, and a school-based mobile dental clinic. The Health Center is a model for health care delivery in rural communities, and offering these services under one roof provides optimal patient-centered health care. The success and growth of The Health Center is attributed to its employees' knowledge and skills, and their commitment to providing outstanding patient care and customer service. The Health Center provides many learning opportunities and supports and encourages staff to obtain certifications. Our employees are part of a team which values the individual strengths that each employee brings to our work.
The Health Center offers a robust benefits package for full-time employees:
- You would accrue up to 2 weeks of paid vacation, earning an additional day a year maxing out at 4 weeks
- You would accrue 96 hours of sick leave annually
- Continuing education sponsorship
- You pay an affordable pre-tax bi-weekly health insurance premium contribution
- The Health Center pays 80% of your health insurance premium
- The Health Center pays 90% of your health insurance plan deductible
- The Health Center pays 100% of the deductible if you have services onsite, woman’s health, or associates in pediatrics
- If you do not need health insurance you would receive $200 per bi-weekly pay period ($5,200/year)
- We offer pre-tax Flexible Spending Account and Dependent Care plan options
- We also offer a retirement plan with employer contribution after 1 year
- After 3 months of employment, short/long term disability and $50,000 life insurance coverage paid 100% by The Health Center
- Dental Benefit- $500 per year for employee, then 60% off discount up to $1,000. Spouse/Dependents- 60% off the first $1,000 (for services at The Health Center)
Job Type: Full-time
Pay: $21.39 - $25.75 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
Schedule:
- Day shift
- Monday to Friday
Work setting:
Application Question(s):
- As an FQHC we follow the CDC recommended vaccine schedule including boosters. COVID and such recommended vaccinations and boosters are a condition of employment. These are paid for by the employer. Do you agree to remain current on all CDC recommended vaccines?
Ability to Relocate:
- Plainfield, VT 05667: Relocate before starting work (Required)
Work Location: Hybrid remote in Plainfield, VT 05667