Quality Coding and Education Coordinator (CPC)

Job Description

Job Description

Description :

HighFive Healthcare is seeking a highly skilled and detail-oriented Certified Professional Coder to join our organization. Primary responsibilities will include accurately translating dental and medical procedures and services into appropriate billing codes, ensuring smooth and timely reimbursement from insurance companies / third-party payers, establishing training and education programs for our doctors, practices and revenue cycle specialists; and reviewing payor agreements to ensure coding compliance.

Our Homebase team is based in Birmingham, Alabama. We are open to both local and remote candidates for this opportunity.

Duties and Responsibilities

• Coding and Billing : Ensure the practices accurately assign relevant dental and medical codes (CDT, CPT, ICD-10, HCPCS) to dental procedures, diagnoses, and services for proper billing and claims submission. This includes translating dental-specific information into standardized medical codes recognized by insurance companies.
• Documentation Review / Audit : Collaborate with dental practitioners and staff to review patient charts and encounter documentation to ensure completeness, accuracy, and compliance with coding guidelines.
• Compliance and Regulations : Keep abreast of changes in dental and medical coding guidelines, billing regulations, and dental procedures to ensure compliance with industry standards and legal requirements.
• Data Management : Maintain accurate and up-to-date records of all coding-related activities, patient encounters, and insurance interactions using the practice management software.
• Training and Education : Provide training and support to dental practice administrative and clinical staff on coding best practices, documentation requirements, and insurance billing procedures. Develop educational programs for identified opportunities throughout the organization.
• Revenue Cycle Optimization : Collaborate with the revenue cycle team to identify opportunities for improving billing processes, reducing denials, and ensuring appropriate coding compliance.
• Work with / report to Clinical Governance Committee on educational process / plan and how to address challenging situations.
• Assist with review of payor contracts and practice education related to payor contractual obligations.
• Provide high level report out quarterly on coding optimization, educational opportunities, payor contract opportunities and plans to address for executive team / Clinical Governance Committee and participate in relevant meetings as requested.

Requirements :

Dental Assistant Benefits Opportunities