Certified Professional Coder

Make a Difference. Grow in Your Career. Thrive with Us. About the Role

At Mindpath Health
, we’re on a mission to make mental health care more accessible and more human. As a national leader in mental health services, we empower our clinicians, support our teams, and prioritize care that helps people truly thrive.

Certified Professional Coder (CPC) is responsible for performing professional coding services for the RCM Team, while following AMA and CMS medical coding guidelines. The primary function of this position is to utilize CPT, ICD-10-CM, HCPCS and coding guidelines to ensure accurate coding as it relates to medical documentation. A Certified Professional Coder will provide research and assist in resolving rejections, denials, and any coding/carrier related inquiries.

This role reviews, analyzes, and codes diagnostic and procedural information that determines Medicare, Medicaid, and private insurance payments. The Certified Professional Coder must work to remain up to date on industry coding changes, payer medical policies, and participate in continuing education courses as mandated by certification. This role also provides customer service that meets and exceeds internal and external customer expectations, is an effective communicator who can express themselves daily in a professional manner both verbally and in writing, as well as a proactive professional who can identify trends and solve them in a timely manner.

This position reports to the RCM Manager and will work closely with the RCM Management Team and staff.

This is a fully remote, full-time role in TX, NC, SC, or FL (40 hours/week, Monday–Friday).

• Reviews and audit charge encounters/tickets for correct CPT, ICD-10 and HCPCS for multiple facilities
  and systems.
• Assist with pre and post audits while maintaining compliance with the payer reimbursement policies and
  government regulations as well as Medicare/CMS guidelines.
• Monitor progress resulting from periodic audits and communicate with the Coding Compliance Manager
• Responsible for maintaining required annual CEU’s, and an active certification.
• Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications.
• Analyses medical records and identifies documentation deficiencies.
• Serves as a resource and subject matter expert to the RCM Leadership and peers.
• Reviews and verifies documentation to support diagnosis, procedure, and treatment results.
• Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes.
• Assigns codes for reimbursement, research and compliance with regulatory requirements utilizing
  guidelines.
• Serves as a coding resource to providers, and other department staff.
• Identifies discrepancies, potential quality of care and billing issues.
• Researches, analyzes, recommends, and facilitates plans of action to correct discrepancies and prevent future coding errors.
• Maintain confidentiality regarding patient account status and the financial affairs of the clinic/corporation.
• Thrive in a high volume medical coding and collections environment while maintaining exceptional standards of excellence.
• Perform coding or coding reviews for multiple health care encounters at the stated minimum performance level.
• Analyze code, interpret, and compile medical information/records to document patient condition and treatment.
• Code, prepare and submit clean claims to insurance companies via electronic and paper submissions.
• Responsible for assisting with resolution of healthcare claims and to collect the appropriate amounts as set forth by contracts or out of network reimbursements.
• Provide excellent customer service to patients, providers, and other customers.
• Maximize collections efforts to enhance the overall Accounts Receivable performance.
• Ability to accurately review and bill all secondary and tertiary insurances to correct charges, bill forms and supporting documentation (EOBs).
• Appropriately identify coding related rejected or denied claims, work to ensure that trends are identified and resolved quickly.li>
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