Coding Specialist

TrueCare is a trusted healthcare provider serving San Diego and Riverside Counties, offering compassionate and comprehensive care to underserved communities. We are committed to making healthcare accessible to everyone, regardless of income or insurance status. With a focus on culturally sensitive, affordable services, TrueCare aims to improve the health of diverse communities. Our vision is to be the premier healthcare provider in the region, delivering exceptional patient experiences through innovative, integrated care.

The Coding Specialist is responsible for assisting the department manager and director by providing coding expertise, coding proficiently, accurately, and completely to facilitate the billing and reimbursement process. The Coding Specialist is also responsible for guiding daily production and workflow of coding errors and work queue. S/he will possess a thorough knowledge of coding guidelines, will demonstrate effective problem-solving skills and work with more complex and/or specialized accounts/projects.

Responsibilities:

• Serve as first line support to and answer questions for Charge Review Specialists
• Conduct in-service coding training and ensure that coders/providers maintain proficient coding skills and keep abreast of all new changes in codes and coding guidelines set forth by the regulatory agencies
• Assist in the development, implementation and enforcement of policies and procedures to ensure quality of the coding function
• Provide technical expertise and input to members of the billing team to improve quality of coding/billing operation and appeal process and assure the organization's compliance to billing guidelines set forth by the Centers for Medicare & Medicaid Services (CMS)
• Perform coding and assist as needed with specialty coding, including the more complex and/or specialized accounts/projects
• Coordinate and work collaboratively with clinical and billing staff to obtain office visit charge information and assure timely and efficient billing and charge processing
• Review medical procedures as documented by clinicians for completeness, accuracy and compliance with regulations; ensure that the final diagnosis accurately reflects treatment rendered
• Review all documentation for dates of service, and clinician signatures prior to charge entry, as well as, correct Current Procedure Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and International Classification of Disease (ICD) 10 codes
• Maintain updated coding and billing knowledge to include regularly reviewing Medicare, Medicaid, insurance bulletins and related materials
• Perform quarterly (or as otherwise designated) audit of patient files for accurate coding and documentation, consistent with data quality and compliance guidelines; coordinate with compliance auditor to ensure full compliance and best practices are being followed
• Maintain required billing records, audit reports, files, etc., consistent with compliance guidelines
• Manage meaningful use attestations and clinical and provider compliance for all stages
• Maintain strictest confidentiality; adhere to all Health Insurance Portability and Accountability Act (HIPAA) guidelines/regulations
  
  

Job Requirements:

• High school diploma or equivalent
• Computer proficiency with practice management software, electronic health records, and Microsoft Office applications, including Outlook, Word and Excel
• Knowledge of multi-specialty coding guidelines
• Familiarity with medical billing terminology
• Knowledge of CPT, HCPCS, and ICD-10 coding protocols
• At least two (2) years’ of billing and coding experience in an acute care facility or equivalent setting
  
  

Nice to Have:

• Associates degree in Medical Billing and Coding or Accounting
• Knowledge of healthcare laws and regulations involving major insurance plans, Medicaid and Medicare
• Experience working in a Federally Qualified Health Center (FQHC)
  
  

Benefits:

• Competitive Compensation
• Competitive Time Off
• Low-cost health, dental, vision & life insurance
• Tuition Reimbursement, Employee Assistance program
  
  

The pay range for this role is $25.41 - $35.57on an hourly basis.

TrueCare is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of race, color, religion, creed, national origin, ancestry, sex, gender, age, physical or mental disability, veteran or military status, genetic information, sexual orientation, gender identity, gender expression, marital status, or any other characteristic protected by applicable federal, state, or local law. Our goal is to promote and ensure authentic inclusion, belonging and support for all team members recruited or employed here. In the spirit of pay transparency, we are excited to share the base salary range for this position.

If you are hired at TrueCare, your final base salary (within the pay range), will be determined based on factors such as education, knowledge, skills, and experience. In addition to those factors, we believe in the importance of pay equity and consider the internal equity of our current team members when determining any final offer. Please keep in mind that the range mentioned above is the full base salary range for the role. Hiring at the maximum of the range would not be typical to allow for future and continued salary growth. We also offer generous benefits and retirement plans.

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