Revenue Cycle Coding Specialist

At Jefferson Center, it is our policy and our mission to be inclusive and mindful of the diversity of everyone who comes through our doors. We are passionate about building a community where mental health matters and equitable care is accessible to all races, ethnicities, abilities, socioeconomic statuses, ages, sexual orientations, gender expressions, religions, cultures, and languages.

Under the supervision of the Director of Operations, the Coding Specialist has a deep understanding of revenue cycle, charge capture and coding processes. The coder is a revenue-driven, highly accurate, credentialed, expert level coder who conducts focused reviews of billing and patient records to identify areas prone to coding errors, identify nature of the errors, and determines appropriate training opportunities to facilitate improvement in coding accuracy. The position requires broad-based and in-depth knowledge and experience coding for healthcare services including facility and professional fee (E/M proficiency), knowledge of Healthcare Common Procedure Coding System (HCPCS), and Medicare and Managed Care reimbursement and contractual arrangements. The certified coding specialist is responsible for ensuring consistent and standard business practices for billing in alignment with billings standards and rules and works with various teams to identify revenue opportunities and compliance risks. This position works closely with members of the Practice Operations & Effectiveness (POE) team, Contracts & Compliance, and Finance/Billing. This position is hybrid remote.

Education, Knowledge, Skills & Experience Required:

• Requires at least an associate’s degree in health information management or related field; a bachelor’s degree is preferred.
• Must be a Certified Coding Specialist (CCS), with Certified Professional Coder (CPC®) preferred.
• A minimum of 3 years’ experience in coding, with minimum of 2 years’ experience in behavioral health and/or substance use setting.
• Experience using electronic health record is required.
• Knowledge of the Colorado State Behavioral Health Service Billing Manual for Medicaid (Colorado Behavioral Health Administration), as well as thorough knowledge of the ICD-10, DSM-5, and CPT/HCPCS coding classification systems is required.
• Knowledge of BHA and CMS rules and regulations and working with various 3^rd party contracts is required.
• The position should have a thorough understanding of medical record practices, standards, coding rules and regulations.
• Strong verbal, critical thinking, communication, and writing skills and a high degree of personal ethics and integrity.
• Demonstrates strong time management, the ability to work independently, and balance multiple priorities and is proficient in Microsoft Office suite including Office 365, Outlook, Word, Excel, PowerPoint, and SharePoint.

Essential duties:

• Reviews electronic health records to ensure accurate coding, identifying both revenue opportunities and potential coding compliance issues.
• Performs payment audits confirming compliance with contract rates.
• Specializes in coding procedures in patient records, ensuring codes meet federal regulations and insurance standards, and documentation is complete and accurate.
• Uses medical terminology to assign ICD-10 and CPT or other codes to diagnosis, treatments, and procedures for accurate reimbursement.
• Identifies coding problems and inconsistencies and makes recommendations regarding coding best practice improvements and coding workflows.
• Works collaboratively across the Center to identify trends, billing opportunities and provider training needs.
• Uses computer applications to assemble and analyze patient data for the purposes of revenue cycle optimization and improving patient care.
• Conducts target audits.
• Remains current on coding guidelines and requirements to ensure compliance with federal and state regulations.
• Makes independent decisions regarding accurate ICD-10, CPT, HCPCS and/or CMS code assignments.
• Work with providers to ensure compliance with coding requirements, and aids in the resolution of billing discrepancies.
• Collaborates with the Quality Manager to develop training materials and provide training related to documentation, coding, clinical processes and guidelines, process improvement, and compliance.
• Participates in the Center’s Coding Committee, providing expertise in answering billing/coding questions submitted by various programs.
• Maintains the highest levels of strict integrity and confidentiality of proprietary and confidential provider, clinical, and organizational information at all times.

Other Duties:

1. Ability to define problems, collect data, establish facts, and draw valid conclusions as it relates to review of electronic medical records documentation and accurate selection of codes.
2. Perform activities complying with code of conduct and mission and value statements.
3. Maintains a positive working relationship with other team members.
4. Actively participates in team meetings and work groups.
5. Other duties, as assigned.

Note: Employees are held accountable for all duties of this job. This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the job.

Salary Grade 13 - $60,400 to $76,800

Additional Salary Information*:

• The salary range above is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE.*

Application Deadline: 3/14/2025. Review of applications will begin immediately. 

Salary : $13,000 - $60,400