Primary Care Clinic Coder


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two professionals working from home. Image text: Full-Time / Remote w/in Nebraska Primary Care Clinic Coder

Hello, We Are ruralMED!

Join our mission of supporting rural healthcare through collaboration focused on strategically tailored services, effective leadership, and industry-specific expertise.

When you join our team as a Primary Care Clinic Coder, you are not just responsible for providing inpatient professional evaluation and management coding services for office visits at family practice specialty clinics, rural health clinics, and outpatient specialty clinic encounters. You get to play a vital role in supporting rural healthcare facilities and the communities they serve. By utilizing sound knowledge of coding rules and regulations, best practice workflows, and the use of multiple software systems to provide timely and accurate coding of medical claims to ensure maximum reimbursement for services provided.

How This Role Makes an Impact:

  • Utilizing your knowledge and skill set, you will experience the rewarding satisfaction of supporting rural healthcare facilities on their journey to thrive within the evolving landscape and achieve excellence.
  • You will work alongside a team of dedicated and driven experts who are passionate about helping each other to be the best at supporting rural healthcare with their revenue cycle and coding prowess.
  • Applying your problem-solving and critical thinking skills, you will be empowered to take ownership and to think outside of the box to develop processes and workflows that continue to further enhance our efficacy and accuracy.
  • You will play a direct role in being a go-to expert for clients and facilities to aid them in maximizing their reimbursement.

What It’s Like Working at ruralMED:

  • Our elite and highly skilled team is driven by delivering top-notch results and supporting each other to reach a new level of excellence while making a positive impact on our clients and rural healthcare.
  • Discover flexibility and autonomy with a company that understands the true value and benefits of work-life balance.
  • Personal and professional growth opportunities are encouraged, and employee engagement is not just a measurement, it is a valuable tool for achieving brilliance.
  • Our core values are not only motivational, but they are also the standard for how we conduct and take pride in our work.
    • It Begins With You: Own it.
    • Pave the Way. Never Settle.
    • Be Thoughtful. Be Transparent. Be Extraordinary.
    • Work Fearlessly. Celebrate the Wins.
    • Capitalize Our Strengths. Achieve Excellence.
  • Learn more about our team: https://ruralrevcycle.com/join-our-team/

How to Succeed in this Role:

  • Excellent Analytical, Critical Thinking, Problem-Solving, and Adaptation skills.
  • Possess 3-5+ years of medical coding experience and knowledge.
  • In-depth knowledge of evaluation and management (E&M) coding sets.
  • Strong communication and collaboration skills.
  • Ability to take direction and work independently.
  • Experience coding for Family Practice Clinics and/or Family Medical Clinics (preferred)
  • Experience coding for Critical Access Hospitals (preferred)
  • Knowledge of medical terminology is a must-have.
  • Thrive in a fast-paced atmosphere and able to flex and adjust to the highest priorities.
  • Character Traits: Solution-Based, Highly Motivated, Achiever, Positive, Genuine, Driven, Self-Disciplined, Knowledge-Seeking, Responsible.

Stand Out and Get Bonus Points!

  • Possess experience and knowledge of Family Medicine, Rural Health Clinic, and/or Critical Access Hospital coding.
  • Advanced know-how and skills with one or more Microsoft Office programs.
  • Ability to quickly pick up and learn new processes, methods, technology systems, and platforms.


Title: Primary Care Clinic Coder

Department: Revenue Cycle Resources

Reports To: Coding Director

Supervises: None

Status: Full-Time, Non-Exempt


Position Summary:

The Primary Care Clinic Coder will be responsible for professional clinic coding, including but not limited to, professional evaluation and management office visits, ER, obstetric, observation, and inpatient. They will ensure the timely and accurate coding of medical claims. Furthermore, they will ensure maximum reimbursement for services provided by utilizing sound knowledge of coding rules and regulations, best practice workflows, and the use of multiple software systems.


Qualifications:

Education and/or Experience:

• High School Diploma is required, Associates is preferred.
• Three to five years medical coding experience is required.


Licenses/Certifications Required:

  • Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) required.


General Requirements/Job Duties:

To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The requirements listed below are representative of the knowledge, skill, and / or ability required:

Charge Entry:

  • Receive and review charge entry data from practice sites.
  • Identify and investigate incomplete or missing charges.

Coding:

  • Abstracts clinical information; translates medical documentation into diagnoses and procedural codes while utilizing currently accepted coding and classification systems.
  • Sequences codes according to established guidelines.
  • Thoroughly analyzes and interprets medical information, medical diagnoses, coding/classification systems, to ensure accuracy for prospective payment system reimbursement.
  • Conducts training for physicians/staff on coding and or documentation practices.

Other:

  • Maintains current knowledge of coding rules and regulations as designated by the AMA, Centers of Medicare and Medicaid Services (CMS) and other payers.
  • Maintains proficient knowledge of EHR, as well as any other systems, required for performing required job duties.
  • Reviews and researches coding denials and advises on appeal verbiage/ coding changes.
  • Communicates issues to management, including payer, system, or escalated account issues. Identifies medical necessity denial trends and provide suggestions for resolution.
  • May perform other billing functions including claim submission, unpaid claims follow-up, denial resolution.
  • Participates in department meetings, in-service programs, and continuing education programs.
  • Maintains a professional attitude with patients, visitors, physicians, office staff and hospital personnel. Assures confidentiality of patient information, maintaining compliance with policies and procedures.
  • Performs other duties as assigned.


Required Knowledge, Skills and Abilities:

  • Three to five years medical coding experience is required.
  • Knowledge of medical terminology is required.
  • Proficient with Microsoft Office


Security/Access:

• Remote work is expected 100% of the time unless otherwise agreed upon.
• Will have access to confidential information abiding by the organizations privacy policies and regulations concerning this information.


Equipment Used:

• General office equipment to include: fax, copier, computer, printer, etc…
• Telephone


Patient Age Groups Served:

None.


Essential Work Environment & Physical Requirements:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.