Primary Health Solutions
201 - 500 employees
🏥 Healthcare
⚕️ Healthcare Insurance
🤝 Non-profit
Healthcare • Healthcare Insurance • Non-profit
Primary Health Solutions is a leading Federally Qualified Health Center (FQHC) in Southwest Ohio, focused on improving community wellness by providing access to quality, affordable, and integrated primary healthcare. The organization operates nine health centers, including four school-based health centers, and offers a variety of services including primary care, dental, pharmacy, behavioral health, and more. They serve all community members regardless of their ability to pay and emphasize collaboration with other healthcare providers.
Certified Coder
🔥 21 hours ago
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Primary Health Solutions
201 - 500 employees
🏥 Healthcare
⚕️ Healthcare Insurance
🤝 Non-profit
Healthcare • Healthcare Insurance • Non-profit
Primary Health Solutions is a leading Federally Qualified Health Center (FQHC) in Southwest Ohio, focused on improving community wellness by providing access to quality, affordable, and integrated primary healthcare. The organization operates nine health centers, including four school-based health centers, and offers a variety of services including primary care, dental, pharmacy, behavioral health, and more. They serve all community members regardless of their ability to pay and emphasize collaboration with other healthcare providers.
📋 Description
• Review provider documentation and translate services into correct codes • Append payer-specific modifiers and claim criteria when applicable • Review incomplete encounters and code based on available EHR documentation • Create and bill encounters using computers and billing software to generate clean claims • Attend internal meetings relevant to EHR workflows and share coding best practices • Assist Operations with coding guidance for existing or new services • Apply knowledge of payer reimbursement and PPS visit qualification for Medicare and Medicaid • Trend areas requiring provider training or retraining • Monitor, trend, and resolve coding edits, rejections, and denials • Communicate with providers, patients, and insurance payers • Review patient accounts and correct missing or inaccurate information • Investigate and appeal incorrectly denied claims • Complete quarterly or ad hoc provider chart audits and other coding projects • Adapt to billing software updates and changes • Assist with training office staff on billing and coding updates • Maintain patient confidentiality and information security • Investigate and report suspected insurance fraud • Perform other assigned duties
🎯 Requirements
• Knowledge and experience with medical terminology • Multitasking, organizational, and team skills • Proficiency with computers, Microsoft Office 360 (Outlook, Word, and Excel), Adobe, and medical billing software • Knowledge of unfair debt collection practices and insurance guidelines • Understanding of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS code classifications • Communication skills with patients and healthcare companies • Basic accounting and bookkeeping practices • Ability to read and interpret safety rules, operating and maintenance instructions, and procedure manuals • Ability to write routine reports and correspondence • Ability to speak effectively before customers or organizational employees • Ability to solve practical problems with limited standardization • Ability to interpret written, oral, diagrammatic, or schedule-based instructions • Ability to learn practice management systems, electronic medical records, Microsoft Word, text paging, Internet, and Intranet systems • Certified Professional Coder (CPC) certificate with some medical billing experience • Spanish-speaking ability is helpful • Ability to regularly lift and/or move up to 25 pounds • Ability to meet the listed physical demands and work-environment requirements • No direct supervisory responsibilities
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