Organizational Overview:
Manet Community Health Center serves the broad health needs of patients and residents across our service areas by delivering high quality, individualized, culturally sensitive primary care, behavioral health and supportive services for families and individuals of all ages. The health center is a federally qualified community health center (FQHC), fully licensed by the Department of Public Health, accredited by The Joint Commission, recognized by the National Committee for Health Assurance (NCQA) as a Patient-Centered Medical Home, and certified for Diabetes Self-Management Education and Support. A multi-site community-based health center, Manet ensures that our patients have unfettered access to all levels of the health care system and is especially committed to providing services for the medically underserved. Manet has three locations in Quincy, and one each in Hull, Taunton and Attleboro, Massachusetts – with two new sites opening in 2023: a school-based health center in Taunton and a clinic within a Housing Resource Center in Quincy for homeless and housing insecure individuals. Manet is committed to providing community leadership and collaboration to improve health outcomes for the residents and communities we serve.
General Definition and Scope of Job:
The Medical Coder provides coding and coding auditing services directly to providers. This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes.
Core Responsibilities:
1. Organizes and reviews all daily encounter for completeness and accuracy. Tracks any missing encounter forms. Follows-up with site-specific staff on missing data or encounters identified;
2. Maintains knowledge of fee for service insurance payers, State , Federal and Manet discount programs to assure accurate billing procedures;
3. Consistently updates patient and insurance information to maximize accurate billing activities;
4. Participates in meetings and reviews of work progress with supervisor and department colleagues;
5. Interacts with departments to correct information as needed;
6. Demonstrates respect and confidentiality when processing information related to patient accounts and insurance information; and,
7. Edits claims for accuracy before submission to payer.
Minimum Skills, Experience and Educational Requirements:
Required Qualifications:
1. High school education or equivalent experience;
2. 1+ years of professional coding experience;
3. Customer service
4. Basic computer and office suite skills;
5. Basic knowledge of coding guidelines; and,
6. Demonstrated ability to use resources to increase knowledge and problem solving skills
Preferred Qualifications:
1. Previous facility based coding experience;
2. Coding certification to include the following: CPC, CCS, RHIA, and RHIT;
3. Previous managed care experience;
4. HCC/Risk coding experience; and,
5. Experience with HEDIS
Critical Demands of the Job:
1. Manage multiple requests and prioritize appropriately;
2. Ability to function in a faced paced setting with a variety of patients and staff;
3. Attention to details and prompt follow up;
4. Includes walking and standing for long periods of time, sitting for short periods of time, hand dexterity, clear hearing and speaking ability. Must be able to lift a maximum of 1/3 of their body weight;
5. Excellent organizational and interpersonal skills; and,
6. Must be responsive to multiple deadlines.