Job Description

Lake Superior Community Health Center is seeking a Certified or Uncertified Medical Coder.

This position will assist with the coding, analyzing, and abstracting of all medical encounters. Coding is performed in a timely manner utilizing ICD, CPT and HCPC coding guidelines and in accordance with known laws and regulations associated with medical coding. Assist with outside clinics/hospitals/patients with billing questions. Assist with monthly insurance verification. Prepare and send medical insurance claims. Assist Medical Biller with rejections and other claim issues. Backup the medical biller.

Primary Responsibilities:

• Review medical encounters coded by providers for accuracy and completeness prior to approving the encounter for billing.

• Interact directly with office personnel and/or providers for clarification of documentation needed for coding and billing. Develop methodology to track coding discrepancies for feedback.

• Interact with office personnel and/or providers to ensure all encounters and supporting documentation are collected and processed by billing department within established time frames.

• Create and submit electronic and paper insurance claims using computerized practice management system, ensuring that claims are submitted accurately and within timely filing requirements specific to each insurer.

• Review rejected claims and resubmit with corrections as needed.

• Assist the medical support staff in obtaining insurance pre-authorization when required in advance of performing the procedure.

• Assure that established policies, procedures, objectives, HIPAA, Compliance Plan and state and federal rules and laws are understood and followed.

• Attend Compliance Committee, QI, and Staff Meetings.

• Assist outside clinics/hospitals with billing questions, etc.

• Acquire and maintain BH and AODA Prior Authorizations.

• Assist with 304B Insurance and Vaccine Audits (insurance and billing part).

• Assist with patient billing inquiries, payments and payment plans as needed.

• Run reports as needed to complete daily, weekly and EOM billing/coding tasks.

• Processing Sliding Fee Applications as needed.

• Train appropriate personal on billing system.

• Assisting Manager/Supervisor with special projects as requested.

• Regular, punctual attendance is an essential function of the job.

• Perform other related duties as assigned, requested, or required.

Qualifications:

• Possession of a high school diploma or GED certificate.

• Medical terminology, coding, insurance AA degree or coding certification. Ex: AAPC’s CPC.

• Minimum of verifiable two years coding experience in a primary care clinic.

Knowledge, Skills and Abilities:

• Human anatomy and physiology and its interaction with medical terminology.

• ICD, CPT and HCPC coding principals necessary to code for family practice.

• Understanding of HIPAA rules and regulations and the necessity to maintain confidentiality.

• Skills to use independent judgment while assisting in the coding process and awareness to interact in a proactive and positive way with providers.

• Skills necessary to use the phone and provide excellent customer service while communicating with others.

• Skills in using ten key and computer.

• Ability to handle multiple concurrent tasks and maintain orderliness and priority to those being resolved.

• Ability to train others in essential duties and responsibilities.

• Understanding the billing cycle from entry through payment.

Education/licensure/registration:

• Medical coding certification

LSCHC offers excellent wages and a comprehensive benefit plan. LSCHC is an equal opportunity employer.
Fill out an LSCHC applicationand submit, along with resume to: lschhumanresources@lschc.org; or mail to: LSCHC, 4325 Grand Ave, Duluth, MN 55807.

Follow us on --->  Facebook:  https://www.facebook.com/LSCommunityHealthCenter|  Instagram: https://www.instagram.com/lscommunityhealthcenter/ |  Our website is https://lschc.org/.

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