Key Facts

Remote From:

Full time

Mid-level (2-5 years)

English

Hard Skills

ICD Coding (ICD-9/ICD-10) CPT Coding Encoder Pro Medical Necessity Medical Privacy Billing Compliance Management Electronic Medical Record Clinical Documentation Addiction Medicine Medical Practice Experience Outpatient Coding Mental Diseases Clinical Documentation Compliance Management

Other Skills

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Communication
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Time Management
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Teamwork
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Detail Oriented
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Social Skills
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Problem Solving

Roles & Responsibilities

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)

Requirements:

Assign ICD-10-CM and CPT/HCPCS codes with modifiers for services provided in the facility (Professional fee coding) based on documentation in EMR
Review provider documentation to determine appropriate codes for all medical services; ensure codes meet local and national medical necessity guidelines
Review and resolve coding edits and denials; assist with rebilling accounts when necessary
Maintain knowledge of coding guidelines, HIPAA, and payer requirements; meet productivity and accuracy goals (e.g., 95%); participate in weekly team calls and report coding patterns

Crossroads

About Crossroads

Since 2005, Crossroads has been at the forefront of treating patients with substance use disorder (SUD). Currently operating 100+ centers across nine states, we are a family of doctors, nurse practitioners, counselors and professionals dedicated to providing the most accessible and highest quality treatment options to combat the growing substance use epidemic. We create individualized treatment plans that use evidence-based medication-assisted treatment and behavioral health therapies to help those with SUD pave their paths to recovery. The outcomes are often lifesaving and lead to significantly improved lives for our patients, their families and their communities.

Founded: 2018

Company size: 501 - 1000

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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.
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.

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.