Certified Medical Coding Specialist

About the role

Elica Health Centers is dedicated to providing exceptional healthcare services to underserved communities. We operate Community Health Clinics and a mobile medicine program called Health on Wheels, and we also offer a Resource Center to empower patients and the community.

Responsibilities

• Audit assigned claims for accuracy and appropriateness.
• Maintain accuracy and stay within coding metrics specific to the specialty and provider.
• Process required number of claims per work week.
• Work in different billing platforms.
• Prepare and submit Special Programs for payer submission.
• Process Medical Insurance claims for payer submission.
• Post payment from all sources.
• Handle and respond to denials and payer requests.
• Assist with other duties as assigned.

Qualifications

• Current Certified Professional Coder (CPC from AAPC) required.
• Minimum of 2 years of coding and billing experience in a healthcare setting.
• Previous experience with coding for outpatient Primary Care and Specialty coding.
• CPT/ICD 10 coding knowledge.
• Previous experience with Medical Billing Software, OCHIC Epic preferred.
• Knowledge of health care third party reimbursement programs, such as Medicare, Medi-Cal, geographic Managed Care Plans and Private Insurance.
• Knowledge of billing, accounts receivables, and collections methods.
• Previous training and HIPAA knowledge is a must.
• Some background in FQHC, RHC, or Community Health Center preferred.

Benefits

• Medical, Dental & Vision Insurance – Choice of PPO medical plans through Anthem Blue Cross, including a Premier PPO option with $0 in-network out-of-pocket costs, plus dental and vision coverage.
• Health Plans include care navigation and provider support resources to help with finding care, understanding benefits, and billing questions.
• Coverage options are available for individual and family tiers.
• Retirement – 403(b) plan with up to 4% employer match and immediate vesting.
• Paid Time Off – Up to 3 weeks of vacation in the first year, plus 7 paid holidays and 1 floating holiday.
• Ancillary & Voluntary Benefits – Employer-paid life insurance, Employee Assistance Program (EAP), Flexible Spending Accounts (Health Care & Dependent Care), and optional supplemental benefits.

Compensation

The compensation range listed reflects Elica’s good-faith estimate of the anticipated hiring range for this position in accordance with California pay transparency requirements. Final compensation will be determined based on job-related factors, including relevant experience, education, certifications, skills, and qualifications.

Language Skills (Preferred)

Bilingual or multilingual communication skills in English and Russian, Farsi, Pashto/Pushto, Hmong or Spanish are preferred to support the needs of the communities we serve, where more than 50% of patients report a primary language other than English.

Requirements

• Current Certified Professional Coder (CPC from AAPC) required.
• Minimum of 2 years of coding and billing experience in a healthcare setting.
• Previous experience with coding for outpatient Primary Care and Specialty coding.
• CPT/ICD 10 coding knowledge.
• Previous experience with Medical Billing Software, OCHIC Epic preferred.
• Knowledge of health care third party reimbursement programs, such as Medicare, Medi-Cal, geographic Managed Care Plans and Private Insurance.
• Knowledge of the methods and practices of billing, accounts receivables and collections.
• Previous training and HIPAA knowledge is a must.
• Some background in FQHC, RHC, or Community Health Center preferred.

Additional Requirements

• Must have a current and valid California driver’s license and the ability to provide proof of personal auto insurance on the vehicle driven during working hours.
• If selected for an employment opportunity with Elica Health Centers, external hires must provide proof of immunizations (Hepatitis B, MMR, Varicella & Tetanus), tuberculosis clearance, and proof of COVID-19 vaccination status* prior to their scheduled start date.

Physical Requirements and Work Environment

The work environment is characteristic of normal office conditions. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is frequently required to sit; use hands to handle or lift. The employee is occasionally required to stand; walk; and reach with hands and arms. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision and ability to adjust focus. The employee must also possess hearing and speech to communicate in person and over the phone. The noise level in the work environment is usually quiet.

Reasonable Accommodations

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Elica Health Centers is a healthcare facility that adheres to the mandates issued by the California Department of Public Health including the recent orders regarding the COVID-19 vaccine.

Medical and religious exemptions will be considered.