Job Description

Job Description

Job Description

Description:

Santa Fe Recovery Center is a leading provider of substance use disorder and mental health treatment and education services. We are looking for a full-time Certified Medical Coder to join our team at our Santa Fe offices. We offer a competitive salary range and the Benefits shown below. Experience working in the Healthcare Industry and/or Non-Profit is highly preferred. This is a great opportunity to continue to advance in your career while being part of the team that is providing support to the community.

Certified Medical Coder Benefits:

• A generous PTO package (3 weeks of PTO, 7 paid holidays, 3 floating holidays, & 2 mental health days)
• Medical, Dental, and Vision insurance (90% to 100% premium covered by employer)
• ST and LT disability
• Pet insurance
• Opt-in 401k with 4% match

Summary:

Access to our comprehensive Employee Assistance Program, providing 24/7/365 access to a licensed professional for staff and their immediate families The CMC, reporting to the Director of Revenue Cycle, verifies, applies, and corrects CPT, HCPCS, ICD-10-CM, and modifiers to claims for behavioral health services. The CMC will perform chart reviews and audits as needed to ensure documentation and claim information adheres to coding standards, compliance regulations, and industry best practices. The CMC may query providers to clarify or correct documentation as needed to ensure compliance.

Duties and Responsibilities of the Certified Medical Coder: (Included but not limited to)

You'll report to the Revenue Cycle Director and:

• Review and analyze patient medical records to ensure proper coding of diagnoses, procedures, and services using ICD-10-CM, CPT, and HCPCS coding systems.
• Accurately code for a variety of services including medical services, behavioral health treatments, IOP services, substance use programs, and other related behavioral health services.
• Review medical documentation to ensure services are properly coded, and provide feedback on required documentation per payor guidelines.
• Ensure compliance with coding guidelines and payor regulations, maintaining accuracy to prevent discrepancies and optimizing reimbursement.
• Collaborate with clinical and administrative staff to ensure complete and accurate documentation supporting coding and billing.
• Support claim resolution processes by coordinating with billing staff to provide coding expertise for denied or delayed claims.
• Effectively utilize and navigate the EMR system for coding purposes.
• Stay current with industry updates, payor guidelines, and coding changes, particularly in behavioral health and substance use treatment programs.
• Maintenance of coding credentials through ongoing education.
• Familiarity with ASAM levels related to the level of treatment for behavioral health services.

Skills/Knowledge/Abilities:

1. Knowledge of CCBHC and CCSS programs is highly desirable.
2. Proficient in ICD-10-CM, CPT, and HCPCS coding.
3. Strong attention to detail and accuracy.
4. Ability to work independently and collaboratively with clinical and administrative staff.
5. Excellent communication skills and ability to explain coding concepts to non-coders.
6. Preferred:
7. Familiarity with CCBHC (Certified Community Behavioral Health Clinics) and CCSS (Comprehensive Community Support Services) service and reimbursement models.
8. Familiarity with managed care organizations and behavioral health coding guidelines.
9. Experience with New Mexico Medicaid and Medicaid Managed Care Organizations (MCOs)
10. Experience handling coding audits and resolving denied claims.
11. Experience with InSync EMR.

Education and Experience:

1. Current certification in Medical Coding from AAPC or AHIMA (e.g., CPC, COC, CCS, RHIT).
2. At least 3 years of experience in medical coding, specifically for behavioral health, substance use treatment programs (outpatient and residential settings).
3. Maintain a current, valid NM Driver’s License. Must also have and maintain a clean driving record and auto insurance
4. Bi-Lingual/Bi-Cultural preferred

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