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Form of workBehavioral HealthMedical Coder & Compliance Coordinator at Educational Service District 112 - WA Tweet Print Application Deadline 4/30/2024 11:55 PM Pacific Date Posted 3/22/2024 Contact Mayra Najera 360-750-7503 Number of Openings 1 Salary Pay Range 64360.37 - 78304.91 Annually Add'l Salary Info Offers are made at the entry level of the range. Length of Work Year 260 days (year round) Employment Type Full Time Job Description / Essential Elements: Print General Responsibilities The Behavioral Health Medical Coder and Compliance Coordinator is responsible for ensuring that the documentation within the Behavioral Health record meets compliance with WAC, RCW, and other state and federal guidelines, and that the codes assigned within the electronic health record (EHR) meet legal, federal and insurance regulations so that payments for service delivery are obtained in a timely manner. Salary: The full annual salary range is $64,360.37 - $78,304.91.
Offers are made at the entry level of the range. Assignment: This position will be full-time and work year-round. Business hours are Monday to Friday from 8:00 am to 4:30 pm.
Essential Functions/Other Functions Essential Functions: Conduct routine coding audits of Behavioral Health records checking for missing and/or incorrect documentation. Review medical record documentation to ensure that Behavioral Health staff are practicing within their credential/scope. Work with Director of Behavioral Health to identify payor remedies should oversights be identified resulting in incorrect insurance submissions.
Develop a monitoring/auditing process to include standardized report functions that utilizes the electronic functionality of the EHR. Identify claims errors, vulnerability, and compliance risk to include missing/improper codes. Work with fiscal staff to identify payor specific contract terms to ensure that payor notifications and terms are consistently adhered to.
Meet with clinical supervisors to review audit findings and recommend ways to improve documentation and compliance when indicated. Stay abreast of coding/billing regulatory changes/updates and communicate the implications of these changes to internal stakeholders to facilitate a compliant organizational response. Review and assist in development of training documents, policies, and procedures to ensure they reflect current state and federal regulations.
Assist with training Behavioral Health staff on code specific documentation and revision of EHR prompts toward that end. Other Functions: Participate in meetings as directed by supervisor. Other duties as assigned.
Minimum/Preferred Qualifications & Skills Minimum Qualifications: Associate's degree or higher in healthcare administration or related field. Three years of Medicaid related experience in a supervisory role. Demonstrated proficiency in medical record analysis and ICD-10CM/CPT coding methodology, guidelines and knowledge and understanding of medical and Behavioral Health terminology.
Knowledge of billing and other coding edits, Centers for Medicare and Medicaid Services (CMS), managed care and private insurance billing regulations. Strong quantitative, analytical, interpersonal, written and communication skills. Ability to communicate effectively both verbally and in writing strong listening skills, can work independently and ability to meet deadlines.
Preferred Qualifications: Bachelor's degree or equivalent number of credits in Business Administration, Health Care, or related field. Five years' experience in regulatory healthcare operations compliance. Working Conditions/Employment Requirements Working Conditions: Valid driver's license.
Travel to districts in the ESD 112 region. Flexible and extended hours may be required to accommodate meetings or travel. Employment Requirements: Successful completion of a criminal history records and fingerprint background check through the Washington State Patrol and FBI.
Requirements / Qualifications Requirements / Qualifications CalPERS Links Not all postings qualify for CalPERS. Informational Only. CalPERS Retirement Benefits ADD TO WISHLIST VIEW JOB WISHLIST APPLY (Current Employees ONLY) APPLY
