Certified Coding Specialist
Johnson Service Group
Johnson Service Group (JSG) is seeking a Certified Coding Specialist in Orange County, CA. This is an On-site position.
Full time- 6 month contract.
Work Schedule: Monday- Friday (8:00am- 5:00pm)
Pay range: $28.00-$40.00 per hour DOE
Duties and Responsibilities include: 95% - Program Support Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department. Supports the manager in ensuring current coding methodology and modifier rules are applied to appropriate reimbursement and ensures the organization is following Medicare and Medi-Cal protocol for payment of claims. Maintains and monitors code listing updates for International Classification of Diseases (ICD)-10-Clinical Modification (CM)/Procedure Coding System (PCS), Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) as needed for all lines of business. Assists the manager with identifying questionable billing practices based on coding protocol. Responds with advice and instructions to any inquiries related to coding appropriateness and review of documentation provided. Assists the Contracting department with contractual billing requirements based on coding standards by identifying applicable procedure codes according to provider specialty. Presents at provider workshops and assists with provider training on regulations for appropriate coding of medical charts and documentation required to support proper claims submission. Assists other departments regarding evaluation of medical records, procedures or diagnosis code questions; identifies ambiguous or non-specific medical documentation regarding coding protocols related to provider disputes, appeals and coding audits on submitted claims. Stays current on official health care regulations, including reimbursement and documentation requirements related to professional claims billing. Ensures compliance with the standards of ethical coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official guidelines. 5% - Other Completes other projects and duties as assigned. Minimum Qualifications: Bachelor’s degree in public health, health services or related field PLUS 3 years of coding experience with an emphasis on Medicare and Medi-Cal requirements in a managed care environment required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. 1 year of experience working with ICD-10 CM or PCS, CPT and HCPCS coding, medical terminology, human anatomy/physiology and regulatory requirements required. Preferred Qualifications: Experience working with MS-DRG, APR-DRG and Medi-Cal coding assignments as well as Medi-Cal chart auditing. Required Licensure / Certifications: Current Certified Coding Specialist (CCS), Certified Coding Specialist Physician-based (CCS-P) or Certified Professional Coder (CPC) Certification by AHIMA or American Academy of Professional Coders (AAPC) required. Knowledge & Abilities: Develop rapport and establish and maintain effective working relationships with company leadership and staff and external contacts at all levels and with diverse backgrounds. Work independently and exercise sound judgment. Communicate clearly and concisely, both orally and in writing. Work a flexible schedule; available to participate in evening and weekend events. Organize, be analytical, problem-solve and possess project management skills. Work in a fast-paced environment and in an efficient manner. Manage multiple projects and identify opportunities for internal and external collaboration. Motivate and lead multi-program teams and external committees/coalitions. Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
JSG offers medical, dental, vision, life insurance options, short-term disability, 401(k), weekly pay, and more. Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law. #D800
Full time- 6 month contract.
Work Schedule: Monday- Friday (8:00am- 5:00pm)
Pay range: $28.00-$40.00 per hour DOE
Duties and Responsibilities include: 95% - Program Support Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department. Supports the manager in ensuring current coding methodology and modifier rules are applied to appropriate reimbursement and ensures the organization is following Medicare and Medi-Cal protocol for payment of claims. Maintains and monitors code listing updates for International Classification of Diseases (ICD)-10-Clinical Modification (CM)/Procedure Coding System (PCS), Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) as needed for all lines of business. Assists the manager with identifying questionable billing practices based on coding protocol. Responds with advice and instructions to any inquiries related to coding appropriateness and review of documentation provided. Assists the Contracting department with contractual billing requirements based on coding standards by identifying applicable procedure codes according to provider specialty. Presents at provider workshops and assists with provider training on regulations for appropriate coding of medical charts and documentation required to support proper claims submission. Assists other departments regarding evaluation of medical records, procedures or diagnosis code questions; identifies ambiguous or non-specific medical documentation regarding coding protocols related to provider disputes, appeals and coding audits on submitted claims. Stays current on official health care regulations, including reimbursement and documentation requirements related to professional claims billing. Ensures compliance with the standards of ethical coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official guidelines. 5% - Other Completes other projects and duties as assigned. Minimum Qualifications: Bachelor’s degree in public health, health services or related field PLUS 3 years of coding experience with an emphasis on Medicare and Medi-Cal requirements in a managed care environment required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. 1 year of experience working with ICD-10 CM or PCS, CPT and HCPCS coding, medical terminology, human anatomy/physiology and regulatory requirements required. Preferred Qualifications: Experience working with MS-DRG, APR-DRG and Medi-Cal coding assignments as well as Medi-Cal chart auditing. Required Licensure / Certifications: Current Certified Coding Specialist (CCS), Certified Coding Specialist Physician-based (CCS-P) or Certified Professional Coder (CPC) Certification by AHIMA or American Academy of Professional Coders (AAPC) required. Knowledge & Abilities: Develop rapport and establish and maintain effective working relationships with company leadership and staff and external contacts at all levels and with diverse backgrounds. Work independently and exercise sound judgment. Communicate clearly and concisely, both orally and in writing. Work a flexible schedule; available to participate in evening and weekend events. Organize, be analytical, problem-solve and possess project management skills. Work in a fast-paced environment and in an efficient manner. Manage multiple projects and identify opportunities for internal and external collaboration. Motivate and lead multi-program teams and external committees/coalitions. Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
JSG offers medical, dental, vision, life insurance options, short-term disability, 401(k), weekly pay, and more. Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law. #D800
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