You’re experienced, talented and motivated. You have the discipline, and you want to invest it in an opportunity that will invest in you. You want to add more meaning to the work you do every day.
At ERC Pathlight, our mission lights the way for your passion.
Who we are:
With over 30 locations throughout the U.S. and treatment options available virtually, ERC Pathlight meets patients where they’re at to offer innovative, compassionate, and comprehensive treatment for eating disorders, as well as mood, anxiety, and trauma-related disorders.
We were founded in 2008 by pre-eminent psychiatrists and psychologists and treat 6,000+ patients per year. With the critical need for mental health care and eating disorder treatment, we’re looking for passionate and qualified professionals who will live out our mission to help save the lives of our patients.
What you’ll be doing:
This is by no means a “behind-the-scenes" role, as your work will help the company serve patients daily in a multitude of ways.
The Certified Medical Coder (CMC) will perform a comprehensive review of clinical documentation and assign CPT, HCPCS and ICD-10 codes to ensure compliance with coding practices for medical and behavioral encounters for patients in Inpatient, Residential, Partial Hospitalization (PHP) and Intensive Outpatient (IOP) levels of care. The CMC must have the ability to determine correct coding and appropriate documentation during the review of clinical documentation. The CMC must also ensure that state, federal and company requirements are met and recognize any concerning billing patterns or trends. The CMC will also be responsible for providing clinical documentation feedback and training to providers.
Essential Duties & Responsibilities:
- Coding:
- Conduct a comprehensive review of clinical documentation and assign CPT, HCPCS and diagnosis codes for both facility and outpatient services.
- Provide detailed written summary of medical record review findings.
- Must be able to articulate findings to auditors, investigators, Medicaid plan leadership, law enforcement, legal counsel, providers, state regulators, etc.
- Identify potential billing errors, abuse, and fraud.
- Identify opportunities for savings related to potential cases which may warrant a prepayment review.
- Ensure coding compliance with federal, state, and other regulatory agencies, research cases, government payors and other selected third-party payors.
- Assist in writing coding policies and procedures.
- Maintain appropriate records, files, documentation, etc
- Training:
- Review and discuss cases with Medical Directors to validate decisions.
- Provide documentation feedback and training to clinicians.
- Develop relevant training programs for the continuous development of clinical staff.
- Research:
- Reviews periodicals and literature to remain abreast of changes that will affect coding and reimbursement methodologies.
- Conducts research on new lines of service, payor rules and governmental regulations
- Proactively obtain and maintain working knowledge of reimbursement guidelines in all states where services are provided.
Qualifications:
- Must have 3+ years’ experience with behavioral health coding in a high-volume environment.
- High school diploma or GED required.
- Associates Degree in Health Information Management or related field preferred.
- AAPC Coding Certification or comparable required.
- Licensed Clinical Social Worker (LCSW), Licensed Independent Social Workers (LISW) or Licensed Master Social Worker (LMSW) preferred.
- Meticulous attention to detail. Strong Organizational skills; Clerical skills. Problem-solving skills.
- Prior training experience.
- Understanding of LCD, NCD, MUE and NCCI edits.
- Expert knowledge in Medicaid and Commercial payors.
- Strong sense of ethics and compliance.
- Proficient in Microsoft Office, Word, Excel and PowerPoint.
- Strong written, oral, and interpersonal communication skills.
- Extensive knowledge of ICD-10-CM and CPT coding methodologies.
- Expert knowledge in E&M codes for behavioral health.
- Experience working both independently and in a team-oriented, collaborative environment.
- Ability and wiliness to travel up to 25% of the time, which may include working occasional evenings and weekends.
What’s in it for you:
Every role at ERC Pathlight is essential to delivering the high-quality care we promise to our patients. This means that from day one, we’re here to support your role whether that means collaborating on monthly/quarterly goals, introducing you to mentors you can learn from, connecting you to continuing education resources and supplying you with the tools needed to not only excel but achieve measurable growth.
What we offer:
Healthy organizations value the mental wellness of their teams, and we understand that the professionals who work for us are not immune to their own mental health conditions. In the same way we observe and guide our patients, we take the same consideration for our employees when building our benefits packages and healthcare offerings. Teammates (and their families) are eligible to enroll in medical, dental, vision, and basic life insurance. Eligible teammates will receive 5.54 hours of paid time off every pay period for your first two years of employment as well as 40 hours of paid parental leave will also be available for use. We also offer competitive pay, 401(K) with company match and tuition reimbursement.
Compensation starting range for the Certified Medical Coder role is $24.00 to $36.00. Ranges are based upon market expectations and are dependent upon candidate experience. ERC Pathlight is hiring for one Certified Medical Coder and we will be accepting applications until 7/1/2024.
#LI-JM1
#IND3
#LI-Remote