Medical Coding Specialist

Community Clinic

Community Clinic is a patient-directed Community Health Center which provides affordable primary health care and supportive services to our neighbors in Northwest Arkansas and Northeast Oklahoma. Community Health Centers, also known as Federally Qualified Health Centers, is a Federal designation whereby community health needs are identified and are responded to appropriately. We provide health care using a Patient-Centered Medical Home (PCMH) approach: the needs of the patient come first. Community Clinic recognizes that every employee plays a vital role. We care. You belong.

Department: Patient Financial Services

Position Reports to: Patient Financial Service Manager

Position Classification: Non-Exempt

Position Description:

The Coding Specialist plays a crucial role in ensuring accurate coding of medical records, facilitating efficient billing processes, and maintaining compliance with healthcare regulations set forth by the American Medical Association and published in the CPT Assistant newsletter. This position requires a strong understanding of medical terminology and coding systems, particularly ICD-10, to support our commitment to high-quality patient care.

1. Essential job functions

• Accurately codes diagnoses and procedures using ICD-10 and other relevant coding systems.
• Abstracts all required data elements via coding technology.
• Reviews medical records for completeness and accuracy to ensure proper documentation.
• Collaborates with healthcare providers to clarify any discrepancies in patient records.
• Assists in the preparation of medical billing and collections processes.
• Maintains up-to-date knowledge of coding guidelines, regulations, and best practices.
• Ensures compliance with all relevant laws and regulations related to medical coding and billing.
• Participates in audits and quality assurance activities to enhance coding accuracy.
• Assists with miscellaneous medical claims projects, staff coverage, peer reviews, and other tasks as needed.
• Ensures that Community Clinic will not cause or allow any organizational practice, activity, decision or circumstance which is unlawful, imprudent, and negligent, contrary to mission, vision or policies or in violation of commonly accepted nonprofit or professional ethics.
• With respect to the treatment of users, does not cause or allow conditions, procedures, or decisions that are unfair, unsafe, undignified, discriminatory or preferential, or fail to provide appropriate confidentiality.
• Ensures that Community Clinic protects our IRS tax-exempt status (501(c)(3)) at all times.
• Able to travel for activities such as meetings, classes, and workshops. Must be able to travel by air as needed to attend training, conferences, and related activities, including overnight travel.

2. Knowledge and critical skills

• Strong background in medical billing processes and medical records management.
• Proficient understanding of medical terminology and its application in coding practices.
• Excellent attention to detail, organizational skills, and ability to work independently.
• Experience in professional billing or coding
• Strong knowledge of eCW, medical billing systems, and clearinghouses.
• Familiarity with CPT, HCPCS, ICD-10 coding, revenue codes, occurrence codes, condition codes and common payer guidelines.
• Ability to work and function independently and within a team.
• Strong interpersonal skills and the ability to work effectively with people of all backgrounds.

3. Qualifications

• High school diploma or equivalent required, Associates Degree preferred.
• Experience in medical coding, including familiarity with DRG (Diagnosis Related Group) coding.
• COC or CPC license or registry from the American Academy of Professional coders.
• Registered Health Information Technologist (RHIT) certification preferred.
• Experience working within a medical office setting is preferred, especially a Federally Qualified Health Center (FQHC).

4. Physical demands

• Ability to sit, stand, walk, bend and stretch in order to retrieve supplies and operate standard office equipment
• Ability to lift, hold and carry objects weighing up to 25 pounds
• Ability to communicate and respond to inquiries both in person and over the phone
• Ability to operate a PC / laptop and other office equipment
• ADA: The employer will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990

5. Accountability for Results

• Performance will be measured by ability to meet or exceed productivity benchmarks, Key Performance Indicators (KPIs), and monthly SMART goals.
• An annual performance evaluation will be conducted based on the essential job functions as listed in this description

This job description will be reviewed periodically as duties and responsibilities change with business necessity. Essential and marginal job functions are subject to modification.