Company Overview
Project Vida Health Center is a dedicated non-profit Federally Qualified Health Center serving multiple locations. Affiliated with a community development organization, we focus on providing accessible healthcare alongside housing, education, and social services to support our community’s well-being.
Position Summary:
An FQHC Medical Coding Specialist reviews patient record and assigns accurate ICD-10-CM, CPT, and HCPCS codes to maximize reimbursement and ensure compliance with federal, state, and FQHC-specific regulations (including Medicaid/Medicare). The specialist will identify billing gaps, audit documentation for quality, and liaise with providers to improve coding accuracy.
Key Responsibilities
- Accurate Coding & Auditing: Assign codes for diagnoses and procedures, adhering to current coding conventions for FQHC billing.
- Documentation Review: Review electronic health records (EMRs) to ensure documentation supports medical and behavioral health charges.
- Provider Feedback: Provide education to providers on documentation practices and coding guidelines.
- Compliance: Adhere to HIPAA regulations and CMS guidelines, including Medicare Local Coverage Determinations (LCDs) and NCCI national corrective coding initiative guidelines.
- Claims Management: Review and resolve coding errors that cause denied claims.
- FQHC Specifics: Apply specialized knowledge of FQHC payment models, such as Medicaid PPS (Prospective Payment System) or Medicare FQHC PPS.
Typical Requirements
- Experience: Usually, 1-2 years of medical coding experience, often requiring experience in a clinical setting.
- Certification: Certified Professional Coder (CPC) from AAPC or Certified Coding Specialist (CCS) from AHIMA is typically preferred or required.
- Knowledge: Strong understanding of ICD-10, CPT, HCPCS, and anatomy/physiology.
- Technical Skills: Proficiency with electronic health records (eClinical Works) and Microsoft Office.
Key Competencies
- Detail-Oriented: High accuracy in capturing all services rendered.
- Communication: Ability to discuss coding discrepancies with providers.
- Problem-Solving: Researching complex coding scenarios to meet regulatory requirements.
Pay: $20.00 per hour
Benefits:
- Employee discount
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person
