What are the responsibilities and job description for the Certified Coder position at Bienvivir All Inclusive Health?
Bienvivir All-Inclusive Senior Health (“Bienvivir”) is a community-based, patient-centered, comprehensive health care delivery system that advocates and promotes quality of life, optimum independence, dignity, and choices in a nurturing environment for frail seniors. Since 1987, Bienvivir has served the frail seniors of El Paso, Texas through the provision of the Program of All-Inclusive Care for the Elderly (“PACE”).
PACE is a unique managed care benefit for frail seniors (referred to as participants) age 55 and older who are certified by the state as needing nursing home level care and who reside in a PACE service area. PACE programs coordinate and provide comprehensive medical and support services so that participants can remain independent and stay in their homes for as long as safely possible.
BENEFITS for Full and Part-time employees who work 30 or more hours per week:
We pay 100% of the MEDICAL monthly premiums for Employee Only coverage.
We pay 100% of the DENTAL monthly premiums for Employee Only coverage.
We provide an affordable VISION monthly premium for Employee Family coverage.
We pay 100% of BASIC LIFE for a benefit amount of $10,000.
We offer safe harbor matching contributions for the 403(B) RETIREMENT SAVINGS account.
We offer up to fifteen (15) days of PAID TIME OFF based on paid hours per pay period.
We offer eleven (11) company-observed PAID HOLIDAYS.
We offer education and TUITION REIMBURSEMENT.
We offer MILEAGE REIMBURSEMENT.
Bienvivir is currently accepting applications for the following position:
CERTIFIED CODER
The Certified Coder, under the supervision of the Utilization Manager, is responsible for coding the internal Physician superbill. Coder is responsible to complete the audits and corrections prior to sending superbills for Centers for Medicare & Medicaid Services (CMS) data entry. The coder will utilize the medical charts and assistance from the Bienvivir Senior Health Services (BSHS) internal physicians for superbill and audit completion. The coder may be assigned to communicate with the CMS contact for the required information as needed and for the resolution of audit findings. The coder is also responsible for auditing the completion of all relevant reports retrieved from the CMS system related to the entered data. Provides training to medical professionals and appropriate staff on the use of diagnostic codes, documentation and report interpretation. The Certified Coder is also responsible for a variety of clerical functions and other reasonable duties as assigned.
RESPONSIBILITIES:
CMS program and reports:
Will follow the BSHS CMS system manual and clinic departmental policies and procedures.
Responsible to be knowledgeable of all aspects of the coding division.
Responsible to code the superbill by utilizing the BSHS physician's documentation from the medical charts.
Responsible for auditing the medical chart documentation for the internal superbill prior to submitting for CMS data entry.
Responsible for follow-up and audit all the relevant reports from the CMS system on the data submitted from the internal superbill.
File system and data documentation
Responsible for keeping the implemented file system for the collected information and the entered data.
Responsible for reviewing all reports retrieved from the initial claim submissions, rejected claims, the re-submitted claims, and all other relevant reports.
Responsible for updating and maintaining the CMS training manual and the CMS information binder.
Meetings:
Responsible for attending committee meetings relevant to the coder position.
Responsible for attending the department's staff meetings or obtaining the information from the supervisor.
Contact personnel: Responsible for communicating with the internal physicians on issues concerning superbill and medical chart documentation.
Training: Responsible for providing training to the internal medical professionals and any appropriate staff on the use of diagnostic codes, documentation and CMS coding reports.
Duties as assigned
Responsible for travel and work at all centers.
Responsible for a variety of clerical functions and other reasonable duties as assigned.
QUALIFICATIONS / REQUIREMENTS:
1. Coding Certification through an accredited institution.
2. 1 Year Coding experience.
