Coding Compliance Specialist jobs in Muskegon, MI

Caring for others can change your world & our community!

Actively seeking a Medical Billing & Coding Specialist team member as critical member of our patient care team for our long-standing, engaged clinic in Traverse City -- Traverse Health Clinic!

"It’s our mission at Traverse Health Clinic to provide high quality, team-driven primary care, behavioral health, and support services that are accessible to EVERYONE in our community, ensuring that no one’s health gets left behind."

Learn more about us @ https://www.traversehealthclinic.org.

We are not large, but have been a mighty Clinic in TC for over 45 years uniquely supporting both Primary Care and Behavioral Health services in one location.

Full-time; benefit eligible position (medical, dental, vision, STD, life insurance) with generous paid time off provisions; competitive wage; 401k eligible/match; paid holidays. Stable hours, 5x8hr or alternative 4x10hr schedule, NO WEEKENDS.

Enjoy a highly rewarding role in healthcare with year round work/life balance!

RESPONSIBILITIES:

• Completes and verifies ICD-10 coding. Responsible for reviewing, researching, coding, and generating third party billing for a health clinic setting involved in primary care, behavioral health and related services.
• Performs professional, accountable, respectful customer care for routine patient follow-up and inquiries corresponding to scope of position.
• Inputs and maintains all payment records in assigned databases and/or systems.
• Reviews insurance payments and denials, and recommends billing corrections.
• Audits medical records to ensure compliance with Clinic’s coding procedures and standards.
• Reviews appropriateness of CPT-4/ICD-10 coding and determines if care provided corresponds to charges submitted.
• Determines extent to which patients' insurance covers their treatments.
• Trains staff members on coding processes.
• Assists as may be needed in identifying fraudulent non-plan billing practices and assists with compliance and finance oversight with resolution and/or preparation pertaining to this.
• Ensures compliance with Federal and State regulations and Clinic policies that govern Medicare and state payment systems.
• Coordinates Medicaid eligibility and enrollment, sliding fee processes, or payment plans amounts with Patients Services team.
• Supports Quality initiatives by periodically reviewing current patients at specified intervals to certify their eligibility for continuing benefits and reminds/schedules them where appropriate with a designated team member to come in for care, using the Clinic’s scheduling guidelines.

QUALIFICATIONS:

• High school diploma or GED required; Associates degree or higher preferred.
• Certification attained, such as CPC (Certified Professional Coder) certification from the American Association of Professional Coders. If not actively current and attained, depending on length and scope of recent experience performing billing and coding functions, consideration may be made to support action for certification attainment while actively performing position with a timeline for completion.
• At least 2-4 years of recent, applicable and related billing and coding experience, and in a FQHC (Federally Qualified Health Center) setting preferred.
• A minimum of 2 years of combined experience in customer service, patient registration, health records; or other medical office experience preferred, or equivalent combination of education and experience.
• Must be self-directed; able to maintain confidentiality, handle crisis and tolerate stress professionally.
• Proficiency in working with various computer programs and databases, particularly Microsoft Office. Experience with electronic medical records required.
• Strong data entry, book keeping skills. Excellent understanding of insurance payments and adjustments.
• Strong understanding of medical billing/coding and related terminology.
• Prior experience and proven ability to work as a team member in a team setting. Prior experience and proven ability to work with the public. Excellent interpersonal skills.
• Excellent organizational; attention to detail, project management skills.
• Familiarity with office practices, procedures and policies.
• Ability to relate well with diverse populations of varying socio-economic backgrounds.

THCC is an equal opportunity employer. THCC extends employment opportunities to qualified applicants and employees without regard to age, race, color, sexual orientation, sexual identity or expression, religion, national origin or ancestry, pregnancy, marital status, veteran status, uniformed service member status, genetic information (including testing and characteristics), physical or mental disability unrelated to the employee’s ability to perform their job and/or any other characteristic protected by federal, state or local law.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Professional development assistance
• Referral program
• Vision insurance

Schedule:

• 10 hour shift
• 8 hour shift
• Day shift
• Monday to Friday
• No weekends

Work setting:

• Clinic

Ability to Relocate:

• Traverse City, MI 49686: Relocate before starting work (Required)

Work Location: In person