Medical Coding Specialist

Company Overview Project Vida Health Center is a dedicated non-profit Federally Qualified Health Center serving multiple locations. Affiliated with a community development organization, we focus on providing accessible healthcare alongside housing, education, and social services to support our community's well-being.

Position Summary:

An FQHC Medical Coding Specialist reviews patient record and assigns accurate ICD-10-CM, CPT, and HCPCS codes to maximize reimbursement and ensure compliance with federal, state, and FQHC-specific regulations (including Medicaid/Medicare). The specialist will identify billing gaps, audit documentation for quality, and liaise with providers to improve coding accuracy.

Key Responsibilities Accurate Coding & Auditing:

Assign codes for diagnoses and procedures, adhering to current coding conventions for FQHC billing.

Documentation Review:

Review electronic health records (EMRs) to ensure documentation supports medical and behavioral health charges.

Provider Feedback:

Provide education to providers on documentation practices and coding guidelines.

Compliance:

Adhere to HIPAA regulations and CMS guidelines, including Medicare Local Coverage Determinations (LCDs) and NCCI national corrective coding initiative guidelines.

Claims Management:

Review and resolve coding errors that cause denied claims.

FQHC Specifics:

Apply specialized knowledge of FQHC payment models, such as Medicaid PPS (Prospective Payment System) or Medicare

FQHC PPS.

Typical Requirements Experience:

Usually, 1-2 years of medical coding experience, often requiring experience in a clinical setting.

Certification:

Certified Professional Coder (CPC) from AAPC or Certified Coding Specialist (CCS) from AHIMA is typically preferred or required.

Knowledge:

Strong understanding of ICD-10, CPT, HCPCS, and anatomy/physiology.

Technical Skills:

Proficiency with electronic health records (eClinical Works) and Microsoft Office.

Key Competencies Detail-Oriented:

High accuracy in capturing all services rendered.

Communication:

Ability to discuss coding discrepancies with providers.

Problem-Solving:

Researching complex coding scenarios to meet regulatory requirements.

Pay:

$20.00 per hour

Benefits:

Employee discount Health insurance Life insurance Paid time off Vision insurance

Work Location:

In person