American Behavioral Health Systems, Inc. - Job Description

Job Title: Professional Coder & Credentialing Administrator

Focus Area: Medical Billing ICD-10 codes & supporting clinical documentation, Medical Provider Credentialing & Facility Credentialing, Compliance

Reports to: EHR System Administrator

Job Class: Salary Exempt; $70,000 - $80,000

Location Options: Spokane, WA corporate office; Tumwater, WA corporate office; or remote with ability to travel to company offices in Washington on occasion (approximately four times a year)

Position Overview:

We are seeking a detail-oriented and highly organized Professional Coder & Credentialing Administrator to join our team. This role is crucial in ensuring accurate medical coding and maintaining provider and facility credentialing to support the billing process. The ideal candidate will demonstrate exceptional professionalism and possess a strong background in medical coding and credentialing within the behavioral health sector.

Key Responsibilities:

• Medical Coding Oversight: Review ICD-10 medical codes for accuracy and ensure proper documentation to maintain compliance with coding standards.
• Credentialing Management: Ensure timely and accurate credentialing for providers and facilities, including updating credentialing rosters with contracted payors and maintaining compliance with EHR systems, payor contracts, and national registries.
• Workflow Management: Oversee claim processing from initial documentation review to final approval, claim batching and billing to ensure compliance and reducing claim denials.
• Education & Training: Provide ongoing education to providers to enhance documentation practices and expedite clean claims submission.
• Continuous Improvement: Develop and implement process improvements, troubleshoot issues, and work with the management team to optimize workflows and productivity benchmarks.
• Compliance Assurance: Ensure adherence to government contracts, state regulations, and HIPAA laws. Maintain confidentiality and protect client information in accordance with federal regulations.

Essential Job Functions:

• Oversee medical coding documentation and ICD-10 code accuracy.
• Educate providers to improve documentation and claim processing efficiency.
• Review and verify provider documentation for accuracy and timeliness.
• Approve, batch and submit reviewed medical claims.
• Ensure up-to-date credentialing for all medical providers and facilities.
• Collect and analyze data to support decision-making and goal achievement.
• Collaborate with various teams, including Revenue Cycle Management, Utilization, EHR, Admissions, Finance, and Clinical Departments.
• Respond professionally to supervisor and management directives.
• Uphold patient dignity and confidentiality in all interactions.
• Comply with federal confidentiality laws (42 CFR) and HIPAA regulations.

Competencies, Skills, and Attributes:

• Proficient knowledge of ICD-10 coding.
• Strong leadership and people management skills.
• Highly organized with meticulous attention to detail.
• Ability to work independently and collaboratively within a team.
• Proficiency in Excel, Microsoft Office, and SharePoint.
• Effective communication skills, both written and verbal.
• Capacity to inspire and guide team members through change.

Minimum Requirements:

• Professional medical coding certification/license.
• A minimum of 5 years of experience in professional coding services.
• At least 5 years of experience in the behavioral health sector.
• Ability to pass all prescreening requirements, including criminal background check and drug testing.

Physical Demands and Work Environment:

• Ability to see, hear, sit, stand, lift up to 10 pounds, and walk.
• Prolonged use of a computer keyboard and monitor.
• Ability to work in a business office environment with moderate noise levels.

Application Process:

To apply, please submit (via Indeed posting) your resume detailing your relevant experience and qualifications. We look forward to reviewing your application and discussing how you can contribute to our team.

Job Type: Full-time

Pay: $70,000.00 - $80,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Vision insurance
• Work from home

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Experience:

• ICD-10: 5 years (Required)

Work Location: Hybrid remote in Spokane Valley, WA 99037