Coding Specialist

Join Chimes – and go further to help others go far!  Chimes is a not-for-profit organization that assists people with intellectual and behavioral challenges to achieve their fullest potential.

Our vast array of services — educational, employment, vocational, residential, habilitative and behavioral health — are delivered through a network of national and international affiliates. This allows us to take a comprehensive, holistic approach to improving the lives of every person we serve — those who receive and reap the benefits of our innovative, responsive solutions.

Compensation: $65,000-$68,000

PRIMARY JOB FUNCTION(S):

• Independently performs scheduled audits especially audits that involve receiving medical codes etc, required by the work plan and unplanned investigations
• Provides compliance guidance to personnel
• Answers questions and provides guidance on coding and/or billing issues
• Works with team to determine appropriate corrective action when necessary
• Monitors and respond to certain regulatory request
• Represents the Compliance Department on various committees as requested
• Generates narrative and quantitative reports concerning all activities.
• Prepares information required for designated meetings.
• Contributes to a work atmosphere in a manner which is positive, enthusiastic, respectful and courteous.
• Ability to follow detailed instructions.
• Uses technology for the completion of specified job duties and assists staff in learning to use the technology.
• Attends work regularly according to assigned work schedule and in accordance with Agency policy.
• Attends and participates in in-service training, staff meetings, and other activities to facilitate professional development.
• Works cooperatively with others including staff, supervisors, administrators, co-workers, individuals served, community professionals, customers, vendors, and the public.
• Assist with plans of correction for OHCQ site visit reports within applicable time frame(s) and ensure completion of corrective actions.
• Provides scheduled staff training as determined by the training department.
• Works a flexible schedule consisting of evening hours as needed.
• Assumes other administrative duties, responsibilities and special projects as assigned
• Ability to differentiate between CMS-1500 and UB-04 claims
• Knowledge of Substance Abuse and Mental Health CPT and revenue codes
• Strong familiarity with major commercial insurance plans and policy types, specifically BCBS, Aetna, Cigna, Johns Hopkins, United Healthcare, and Medicaid
• Advance proficiency in Microsoft Office Suite, particularly Excel
• Will be working through ICD9 and ICD10 codes
• Must have strong working knowledge of Medical Terminology

REQUIREMENTS:

Obtain Certified Investigator certification within 90 days of hire

Driver’s license

EDUCATION:

BA Degree

Medical Coding Certification required (CPC OR CPC-A)

EXPERIENCE: 

• Professional level of knowledge of billing practices and procedures
• In depth knowledge in the areas of Medicare and Medicaid, and commercial insurance billing regulations
• Minimum of 4 years’ experience in a healthcare compliance program, however provider payment and healthcare coding experience may be used toward experience requirement
• Familiarity with the healthcare regulatory environment
• Knowledge of basic coding and healthcare licensing/accreditation standards is required
• Knowledge of multi state and federal laws and regulation with affect compliance operations

NOTE: At the discretion of the Personnel Officer, additional related experience and/or education may be substituted in lieu of the requirements specified under Education and Experience.

What’s in it for you?

Total Rewards (For Full-Time Employees = >30 hours/week):

• Medical, Dental, and Vision Insurance
• Flexible Spending Accounts
• Life Insurance
• Disability Insurance
• Paid Time Off
• 403(b) with Company Match
• Transportation Subsidy
• Employee Recognition Programs
• Referral Bonus opportunities
• And More!

Want to learn more?

To learn more about Chimes, and how you can achieve personal and professional growth within a purpose-driven organization, visit us at: https://chimes.org/Careers.

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Salary : $65,000 - $68,000