Assign appropriate ICD-10-CM and CPT/HCPCS codes for professional services while ensuring adherence to medical necessity guidelines. Review provider documentation, resolve coding edits and denials, and maintain compliance with federal regulations.
Requirements summary
Requires a CPC or CCS-P certification, a high school diploma, and at least 2 years of coding experience with an emphasis on Evaluation and Management. Proficiency in MS Office and knowledge of mental health or opioid addiction terminology is preferred.
high schoolprofessional certificateHIPAA ComplianceMS OfficeMedical TerminologyMedical BillingElectronic Medical RecordsHCPCS CodingCPT CodingDenial ManagementProfessional Fee CodingICD-10-CM CodingMedical Necessity GuidelinesEvaluation And Management Coding
Job description
Crossroads Treatment Centers is an equal opportunity employer.
We celebrate diversity and are committed to creating an inclusive environment for all employees.
Since 2005, Crossroads has been at the forefront of treating patients with opioid use disorder.
Crossroads is a family of professionals dedicated to providing the most accessible, highest quality, evidence-based medication assisted treatment (MAT) options to combat the growing opioid epidemic and helping people with opioid use disorder start their path to recovery.
This comprehensive approach to treatment, the gold standard in care for opioid use disorder, has been shown to prevent more deaths from overdose and lead to long-term recovery.
We are committed to bringing critical services to communities across the U.S. to improve access to treatment for over 26,500 patients.
Our clinics are all outpatient and office-based, with clinics in Georgia, Kentucky, New Jersey, North and South Carolina, Pennsylvania, Tennessee, Texas, and Virginia.
As an equal opportunity employer, we celebrate diversity and are committed to an inclusive environment for all employees and patients.
Day in the Life of a Medical Coder Assign ICD-10-CM and CPT/HCPCS codes with modifiers for services provided in the facility (Professional fee coding).
Review all applicable documentation of various providers to determine the appropriate codes to assign for all medical services, procedures, and diagnoses from available documentation within electronic medical records.
Ensures diagnosis codes meet local and national medical necessity guidelines.
Be knowledgeable of billing and coding requirements for governmental and private insurance payers.
Utilize coding resources along with any other applicable reference material available to ensure accuracy in coding for all assigned services.
Demonstrates the technical competence to use the facility encoder and EMR in an office or remote setting.
Review and resolves coding edits and denials.
Assists with rebilling accounts when necessary.
Maintain a working knowledge of various laws, regulations and industry guidance that impact compliant coding.
Follow all HIPAA regulations and uphold a higher standard around privacy requirements.
Benefits
Dental Insurance
Life Insurance
Paid Time Off
Vision Insurance
Medical Insurance
Paid Maternity Leave
Paid Paternity Leave
Short Term Disability
Long Term Disability
401k With Match
Mental Health Day
Annual Continuing Education Allowance
Calm Subscription
Completes all assigned work in a timely manner based on internal and/or payer standards.
Must meet all coder productivity and quality goals; Maintain a 95% accuracy rate.
Attending and reporting at weekly team calls with Director of Medical Coding Compliance.
Reporting coding patterns identified within the coding process to management.
Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-10 materials, the Federal Register, and other pertinent materials.
Adhere to all internal competencies, behaviors, policies and procedures to ensure efficient work processes.
May interact with providers and/or center administrators from time to time regarding billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation.
Other duties and responsibilities pertaining to medical coding compliance monitoring as requested by the Director of Medical Coding Compliance or Chief Compliance Officer.
Schedule, Travel, & Work Authorization Candidates must work 8-hour shifts Monday through Friday.
Candidates may clock in as early as 6:30 AM EST, but no later than 9:00 AM EST.
Training and onboarding are fully on-site.
There is a potential for up to three days a week working remote based on the candidate's ability to consistently meet productivity and quality guidelines.
Education and Licensure Requirements Certified Professional Coder (CPC®) or CCS-P High School diploma, GED or equivalent.
Minimum of 2 years of coding experience with an emphasis in Evaluation and Management coding.
Experience in coding healthcare provider documentation to identify correct ICD-10-CM, CPT, and/or HCPCS codes preferred.
An excellent understanding of Mental Health / Opioid Addiction medical terminology preferred.
An excellent understanding of ICD-10-CM coding classification and CPT/HCPCS coding.
Computer literate adept skill level on MS Office applications.
Experience in Mental Health or Addiction Medicine a plus.
Position Benefits Medical, Dental, and Vision Insurance PTO Variety of 401K options including a match program with no vesture period Annual Continuing Education Allowance (in related field) Life Insurance Short/Long Term Disability Paid maternity/paternity leave Mental Health Day Calm subscription for all employees Crossroads Treatment Centers is an equal opportunity employer.
We celebrate diversity and are committed to creating an inclusive environment for all employees.
Our Story Since 2005, Crossroads has been at the forefront of treating patients with opioid use disorder.
Crossroads is a family of professionals dedicated to providing the most accessible, highest quality, evidence-based medication assisted treatment (MAT) options to combat the growing opioid epidemic and helping people with opioid use disorder start their path to recovery.
This comprehensive approach to treatment, the gold standard in care for opioid use disorder, has been shown to prevent more deaths from overdose and lead to long-term recovery.
We are committed to bringing critical services to communities across the U.S. to improve access to treatment for over 26,500 patients.
Our clinics are all outpatient and office-based, with clinics in Georgia, Kentucky, New Jersey, North and South Carolina, Pennsylvania, Tennessee, Texas, and Virginia.
Our Mission Is Focused: We exist to improve health equity in order to create superior outcomes.
Our Vision Is Clear: To provide the most convenient, comprehensive, high-quality care through specialty medical homes.
Our Culture Is Inspiring: Our culture is based on one simple tenet: we would treat others as we would like to be treated – with respect and empathy.
We pride ourselves on how we serve our patients.
Our INSPIRE culture sets us apart in how we interact not just with patients, but with our communities and each other on a day-to-day basis.
