Patient Billing Coder - Venice Family Clinic

Venice Family Clinic is a leader in providing comprehensive, high-quality primary healthcare to people in need with compassion, dignity, and respect. In November 2021, Venice Family Clinic merged with South Bay Family Health Care, uniting more than a century of experience helping patients regardless of their income, insurance or immigration status. The organization now has more than 500 staff who serve 45,000 people from the Santa Monica Mountains through the South Bay. We have 17 locations, plus two mobile clinics, and an extensive street medicine program for individuals experiencing homelessness. Read more about us at venicefamilyclinic.org

Under the direction of the Revenue Cycle Director, this position:

• Codes, diagnoses, and procedures for a multi-specialty group. In performing the coding requirements, this position is required to utilize knowledge of AHA-Coding Clinic and AMA - CPT Assistant guidelines, medical terminology, anatomy and physiology, and pathological basis of disease, documented treatment and procedures.
• Assigns ICD-10 CM and CPT codes for patients receiving services at Venice Family Clinic.
• Accurately process outpatient claims to third-party payers, following all mandated billing guidelines.
• Provides quality control checks on paper claims; processes tracers, denials, and related correspondence;
• Initiates appeals; drafts, composes, and submits appeal letters specific to coding issues consistent with the most updated American Medical Association Current Procedural Terminology.
• Identifies and reports any potential compliance risks and reimbursement opportunities to the Revenue Cycle Director.
• Other duties may include computer operation using (Excel, Word, MS Office, 3M Coder), data entry and retrieval

Required:

• Certified as a Professional Coder from the American Academy of Professional Coders within one year on hire and must be maintained annually.
• Experience as Medical Record Abstractor and possess extensive knowledge of Medical Record content.
• Good command of English Grammar and oral and written communication skills.
• Detailed knowledge of Medical Terminology and its application.
• Detailed knowledge and understanding of ICD-9, CPT, and HCPCS coding systems.
• Ability to accurately assign ICD-9 and CPT codes.
• Knowledge of CMS and local carrier regulations and requirements for documenting/billing physician services at a teaching hospital.
• Working knowledge of anatomy and physiology.
• Knowledge of HIPAA requirements and ability to maintain confidentiality of sensitive information.
• Ability to meet established continuing education requirements by attending required training workshops, reading materials assigned by AAPC in order to maintain yearly CEUs required for Certified Professional Coder.
• Knowledge of Microsoft Excel and Word.