Peak Vista Community Health Centers is a nonprofit health care organization whose mission is to provide exceptional health care to people facing access barriers through clinical programs and education. We provide integrated health care services to include medical, dental and behavioral health throughout 26 outpatient health centers within El Paso, Teller, Lincoln, Adams, Elbert and Kit Carson counties. We deliver care with our strong “Hospitality” culture. Our organization has over 950 employees and serves more than 94,000 patients annually in the Pikes Peak and East Central regions of Colorado. Peak Vista is accredited by the Accreditation Association for Ambulatory Health Care, Inc. (AAAHC).

Compensation (Pay): $18.64 to $21.44 based on experience.

Summary of Benefits:  

• Medical, Dental, Vision, Life, STD, LTD
• 403(b) Retirement with Company Match
• Paid Time Off
• Tuition Assistance
• Perks Rewards
• Employee Assistance Program

https://www.peakvista.org/careers/employee-benefits-guide

Job Summary: Responsible for understanding the billing requirements for all payors and programs.

Essential Duties and Responsibilities:

• Responsible for understanding the billing requirements for all payers
• Enters and approves data into the Management Information system according to appropriate guidelines to ensure that PVCHC accounts receivable is accurate.
• Responsible for coding and entering hospital charges from charge sheets and/or face sheets within established guidelines.
• Analyzes provider documentation to assure the appropriate Evaluation & Management coding levels are assigned the correct CPT or CDT code
• Provides expertise to Billing staff in addressing appeals for denials for incorrect diagnosis’s for services performed.
• Serves on the Patient Accounts Audit team to facilitate the auditing of provider encounters to ensure compliance and maximize reimbursement.
• Serves as coding reviewer to support the charge posting process.
• Execute daily workload within full compliance of state and federal billing regulations.
• Accept charges, review, analyze, and code diagnostic and procedural information that determines Medicaid, Medicare, CHP+, and private insurance payments.
• The position will require review of ICD-9-CM, ICD-10-CM, CPT, CDT and HCPCS coding for procedures performed by providers.
• CDT and HCPCS coding for procedures performed by providers.
• Conducts periodic Quality Assurance Processes for Patient Accounts Coders to ensure accuracy and policy compliance, in Hospital charges, Coding Review, daily emails, fee tickets and other assigned tasks.
• Tracks and reports the progress of Patient Accounts coders for leadership decision making
• Summarizes and reports the trends of provider documentation and Patient Accounts team production.
• Supports Patient Accounts Coding and Charge Posting Manager in duty assignment and Production Log Review
• Provides initial and ongoing training to provider staff regarding coding compliance.
• Develops training materials for ongoing use by provider staff, and Patient Accounts staff
• Completes charge reconciliation for hospital charges
• Review operational processes for improvement opportunities and participates in organizational PI studies, as needed
• Perform other duties as assigned

Employee demonstrates knowledge of and adherence to the Compliance Plan and conflict of interest requirements. The employee enhances the effectiveness, efficiency and productivity of the department by contributing to, and participating in, departmental performance improve goals.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/Experience:

Education: High School Diploma

Work Experience: Coding certification from an approved body, 2-3 year coding or relevant healthcare experience, 6 months Peak Vista experience

Certificates and Licenses: CPC, CPC-P, CCS-P, RHIA or RHIT certification required.

Computer Skills:

To perform this job successfully, an individual should have knowledge of basic computer skills

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The employee must occasionally lift and/or move up to 50 pounds. While performing the duties of this job, the employee is frequently required to stand; walk and sit.

*Successful candidates will complete pre-employment screening; which includes but is not limited to, a Criminal Background check. Peak Vista Community Health Centers is a drug and alcohol-free workplace and an Equal Opportunity Employer.

**PVCHC participates in the Electronic Employment Verification Program. E-Verify is an Internet-based system that compares information from an employee’s I-9 to data from the U.S. Department of Homeland Security and Social Security Administration Records. To learn more, visit: everify.com