*Who are we?*
As an innovative primary care provider, Avance Care is in the business of improving the standard of healthcare.
By offering convenient, accessible, cost-effective healthcare services, we keep our patients at the center!
*Job Purpose*
To support and maintain coding compliance, and patient risk assessment by applying certified professional coding (CPC) principles to claim documentation process, reducing institutional, legal, and financial risk.
Actively increase revenue, accuracy of payment and quality of care by identifying, trending, and submitting unreported valid medical diagnosis and delegating diagnosis that were submitted inappropriately to relevant payers.
*Core Responsibilities*
* Actively abstract and code daily patient encounters through chart documentation, billing for all services, and appropriate assignment of E&M coding related to chart documentation, time, and medical decision making – E/M 2021
* Thorough understanding of clinic coding (E/M) documentation requirements and HCC concepts impacting population Health Risk Adjustment reimbursement initiatives
* Ability to review documentation and abstract all codes with specific emphasis on identifying the most accurate severity of illness according to CMS HCC guidelines
* Offers recommendations, through actions and trending analysis, to enhance templates and tips for capturing the accurate codes at the patient encounter
* Maintains knowledge regarding policies and procedures with Medicare/Medicaid Carriers and third-party payers, including HCC and RAF guidelines
* Effectively work with and support providers through structured communication as it related to chart documentation and coding practices
* Understand and apply Correct Coding Initiative (CCI) edits and modifiers, as sometimes specifically required by 3rd party payers or Medicare
* Train, address knowledge gaps, questions, and concerns from outsourced-partner coders
* Assign missing procedure CPT, or HCPCS from the Current Procedure Manual and Common Procedure Coding System Manual when necessary
* Aid in the coaching of providers on high specificity ICD-10-CM coding to support Risk Assessment
* Interacts effectively and professionally with colleagues to provide helpful information in response to inquiries, concerns, and requests
* Accomplishes all tasks as assigned or become necessary
*Qualifications*
* Certified Professional Coder Apprentice (CPC-A) through the AAPC, required
* Certified Professional Coder (CPC) through the AAPC, preferred
* Certified Risk Adjustment Coder (CRC), highly preferred
* High School Diploma required
* Associate Degree for Medical Billing and Coding or similar field, preferred
* E&M Coding experience, preferred
* 2+ years relevant experience
*What are we looking for?*
* Knowledge of insurance practices
* Knowledge of CPT, HCPCS, and ICD-10 coding
* Excellent verbal and written communication
* Confidentiality of patient information regarding HIPAA laws
* Strong computer skills
* General math skills
* Strong attention to detail
* Time management and workload prioritization skills
* Standards development and implementation
*Schedule*
* Monday - Friday
* 8am - 5pm
* This position is fully remote after a 30-90 day onsite training period.
Job Type: Full-time
Benefits:
* 401(k)
* 401(k) matching
* Dental insurance
* Disability insurance
* Flexible spending account
* Health insurance
* Life insurance
* Paid time off
* Vision insurance
Schedule:
* Monday to Friday
Work setting:
* Hybrid work
* Office
Work Location: Hybrid remote in Durham, NC 27707
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