Certified Professional Coder
Skylight Health Group
Denver, Colorado
medical
cpc
athena
health
clinical documentation
leadership
education
icd-10-cm
medical records
billing
military
flsa
exempt
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November 6, 2022
Skylight Health Group
Denver, Colorado
Job Description Title: Certified Professional Coder
FLSA Status : Full Time / Non-Exempt
Reports to: Revenue Cycle Manager
Pay Type: Hourly
Pay Range: $22.00 - $26.00, depending on education and experience
Pay Frequency: Bi-Weekly
Location: Remote
Skylight Health Group:
We believe that affordable care should be delivered the way it used to be – highly accessible with uncompromising quality. We are a multi-specialty provider that strives to deliver integrated medical services with compassion and care.
Job Description:
Skylight Health Group is seeking a Certified Professional Coder (CPC) or Certified Professional Biller (CPB) to review clinical documentation as appropriate. The CPC or CPB will extract data and apply appropriate ICD-10-CM, HCPS and CPT codes as defined for the service type.
Essential Job Duties and Responsibilities:
Review and correct claims flagged for review in the following categories: Coding
Medical Policy
Benefits & Coverage
Review clinical documentation in Athena Net to validate claim coding and claim submission.
Make necessary coding corrections based on Athena Net Claim Rules.
Utilize payor resources to correct missing delay reason codes.
Ensure all prior authorizations and medical records are attached as needed per payor guidelines.
Queries to the clinical staff when assistance is needed for proper identification of codes and documentation.
Identify coding trends to relay back to leadership.
Assist as needed with CBO with coding support as needed.
Responsible for review of every claim to ensure coding and scrubbing for coding optimization.
Perform code abstraction of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation.
Identify diagnosis and chart level impairments and documentation improvement opportunities to communicate back to the leadership team.
Ensure charts are closed for timely submissions.
Consistently maintain optimal coding accuracy.
Meet minimum productivity requirements set forth by leadership.
Education and Experience:
High School diploma or equivalent, required.
CPC, CPC-A, CPB Certified and current on CEU's.
Minimum 2 years of Coding and Billing experience with Primary Care and Urgent Care.
Knowledge of Federal, State, Commercial, Military, HMO and W/C payors.
Experience with Athena and/or Multiple Billing Systems a plus.
Advanced knowledge of Microsoft Office and Outlook.
Experience with Encoder Pro or other coding references.
Intermediate Excel skills.
Able to type 40+ wpm.
Athena Net experience is a plus.
This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Supervisory Responsibility
None.
Work Hours:
Schedule, M-F (start times are flexible from 6:30-8:00 local time zone)
Travel:
None.
EEO Statement:
Skylight health is an equal opportunity employer. We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, pregnancy, genetic information, marital status, military or veteran status, or any other status that is protected by federal, state and / or local laws.
If you are based in California, we encourage you to read this important information for California residents linked here
FLSA Status : Full Time / Non-Exempt
Reports to: Revenue Cycle Manager
Pay Type: Hourly
Pay Range: $22.00 - $26.00, depending on education and experience
Pay Frequency: Bi-Weekly
Location: Remote
Skylight Health Group:
We believe that affordable care should be delivered the way it used to be – highly accessible with uncompromising quality. We are a multi-specialty provider that strives to deliver integrated medical services with compassion and care.
Job Description:
Skylight Health Group is seeking a Certified Professional Coder (CPC) or Certified Professional Biller (CPB) to review clinical documentation as appropriate. The CPC or CPB will extract data and apply appropriate ICD-10-CM, HCPS and CPT codes as defined for the service type.
Essential Job Duties and Responsibilities:
Review and correct claims flagged for review in the following categories: Coding
Medical Policy
Benefits & Coverage
Review clinical documentation in Athena Net to validate claim coding and claim submission.
Make necessary coding corrections based on Athena Net Claim Rules.
Utilize payor resources to correct missing delay reason codes.
Ensure all prior authorizations and medical records are attached as needed per payor guidelines.
Queries to the clinical staff when assistance is needed for proper identification of codes and documentation.
Identify coding trends to relay back to leadership.
Assist as needed with CBO with coding support as needed.
Responsible for review of every claim to ensure coding and scrubbing for coding optimization.
Perform code abstraction of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation.
Identify diagnosis and chart level impairments and documentation improvement opportunities to communicate back to the leadership team.
Ensure charts are closed for timely submissions.
Consistently maintain optimal coding accuracy.
Meet minimum productivity requirements set forth by leadership.
Education and Experience:
High School diploma or equivalent, required.
CPC, CPC-A, CPB Certified and current on CEU's.
Minimum 2 years of Coding and Billing experience with Primary Care and Urgent Care.
Knowledge of Federal, State, Commercial, Military, HMO and W/C payors.
Experience with Athena and/or Multiple Billing Systems a plus.
Advanced knowledge of Microsoft Office and Outlook.
Experience with Encoder Pro or other coding references.
Intermediate Excel skills.
Able to type 40+ wpm.
Athena Net experience is a plus.
This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Supervisory Responsibility
None.
Work Hours:
Schedule, M-F (start times are flexible from 6:30-8:00 local time zone)
Travel:
None.
EEO Statement:
Skylight health is an equal opportunity employer. We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, pregnancy, genetic information, marital status, military or veteran status, or any other status that is protected by federal, state and / or local laws.
If you are based in California, we encourage you to read this important information for California residents linked here
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