Job Description

Anticipated Closing Date: 3/31/2025. Applications will be reviewed on a rolling basis.

This position is open to applicants in the states of CO, NM, and NV.

Please complete this form along with this application. 

Position Full Range: $ 27.87/ hour - $ 35.31 / hour.
Starting Pay: Although our full pay range is included above, the budgeted hiring range for this position is $ 27.87/ hour - $ 31.59 / hour.
Hourly, Non-Exempt.
Schedule: Full Time, Flexible Schedule between 8am-7pm, Monday -Saturday.
On-site vs Remote: 10% on-site, 90% remote.

The Objective: Perform all activities related to Planned Parenthood of the Rocky Mountains’ coding program which includes providing coding training and coding audits, ensuring accurate documentation, creating resources, and tools, and providing direct support to licensed staff.

Success: To be successful in this role you must have a deep background in insurance and Medicaid knowledge and medical billing and coding. You must stay up to date with the latest and most relevant payer, CMS, and coding requirements to ensure all elements of the revenue cycle process are coordinated and communicated. You must be a resource for PPRM’s clinicians through ongoing feedback, support, coaching, and training. You will provide accurate audits of provider charts and ensure that clinicians have the tools to institute continual improvement over their coding and documentation performance. Implement coding efficiencies and initiatives to ensure maximum revenue is captured from 3rd party payers.

Snapshot: This is a full time, M-F, benefits eligible position that will require 100% of your time to be in front of your computer with occasional meetings and phone calls. You will work closely with PPRM medical services, health centers, finance and RCM vendor. You will be auditing charts, creating job aids, facilitating training, providing feedback and support for real time questions, and working 1:1 with clinical staff to improve their coding and documentation performance. working with your staff on audit processes (both creating and refining) process improvement, answering questions, updating coding training documents, working with clinicians, and researching billing and coding rules and regulations.

Qualifications:

• You must hold an active AAPC certificate as a Certified Professional Coder (CPC) or equivalent and/or AAPC Certified Risk Adjustment Coder (CRC) or equivalent required.
• Certified Professional Medical Auditor (CPMA) preferred.
• At least three years of medical billing and coding in an outpatient (preferably in an environment which primarily billed preventative or family planning care) office.
• Strong written and verbal communication skills while being particularly adept at communication via telephone & video.
• Strong relationship-building/interpersonal skills. Intermediate knowledge of Microsoft applications, including Excel, Word, PowerPoint, and Outlook, and the ability to use Chrome, Internet Explorer and Microsoft Edge is necessary.
• Experience with NextGen PM & EHR preferred.
• Demonstrated experience performing quality reviews.
• Knowledge of auditing practices and knowledge of ICD-10, CPT, and HCPCS coding are required.
• Ability to meet deadlines and work under pressure.
• Ability to conduct effective training for licensed staff.
• Ability to handle multiple interruptions throughout the day and reprioritize as needed.
• Self-starter with the ability to take initiative, achieve results, and meet deadlines.

Key Approaches to the Work:

• Strategic Thinking
• Communication
• Interpersonal skills
• Inclusion and Equity Champion

Primary Areas of Responsibility/Essential Functions: The Certified Professional Coder conducts efforts related to ensuring the coding integrity of PPRM through auditing and clinical documentation improvement activities for the organization. Develops or contributes to the development of coding and documentation education for clinical staff. Supports the fiscal goals of the organization by providing timely and accurate coding, working with other departments across the organization to meet coding and documentation quality objectives. Ensures revenue integrity through compliant coding and documentation capture approaches.

• Manage Medical Billing and Coding Activities: Your team and colleagues are responsible for ensuring that the organization is paid for services and activities You are an integral part of the coding program and work to ensure that all regulatory, compliance, and contractual practices are aligned with national and payer guidelines. You toggle between macro and micro regularly, moving with ease between high-level data and the details of an individual account when necessary. Among your responsibilities, you will: 
  • Works closely with clinical leadership to monitor and identify coding trends, deficiencies, and opportunities for improvement at Planned Parenthood of the Rocky Mountains to identify areas of risk and seek.
  • Follow audit tools and utilize coding resources.
  • Provides coding support, education, and training to clinical staff.
  • Provides quality audits for clinician services incorporating both coding and clinical documentation in the assessment.
  • Review records for documentation deficiencies and work with the clinician to improve coding and documentation specificity.
  • Monitor denials and report trends to your supervisor.
  • Develop and monitor coding workflow processes, job aids, and template.
  • Oversee the coding program which includes training clinicians, training coders, performing regular audits; monitoring and evaluating program effectiveness and progress; working with the Director of Quality Management and Clinical Training team on improvements and changes; and acting as a liaison with outside coding agency.
  • Ensure that all billing and coding activities meet and adhere to Medicaid, and other insurance and state program regulations, rules, and laws.
  • Maintains proficiency in coding.
  • Research and address coding questions from clinical and billing staff.
• Collaborative Member of Cross-Functional Teams: You bring capacity, perspective and skill to various projects and initiatives across the organization that help strengthen our collective work. You lean in where you have contributions to make and take pride in being a part of collaborative efforts that have impact. Among your responsibilities, you will: 
  • Collaborate with and support other Planned Parenthood affiliates regarding sharing of coding best practices, standardized patient account workflow processes, practice management systems, file maintenance and billing protocols.
  • Participate in performance improvement projects as
  • Participate in the Revenue Cycle Management and other committees as
  • Participate and collaborate with auditors and other PPRM staff during audit fieldwork as assigned.

Abortion Care: We all work in abortion care, whether it is referrals, information, education, counseling, performing, scheduling, etc. In this role, you will work with your team to ensure all patients can utilize the full measure of their insurance coverage to cover their care and ensure all billing training documents are up to date.

Benefits at PPRM include:

• A predictable schedule and dedicated individualized paid training.
• 401K/Safe Harbor Contributions (We contribute 3% of your pay to your 401K after 1 yr even if you don't).
• Medical/Vision/Dental, with extended mental health coverage.
• Employee Loan Program.
• Employee Assistance Program and WorkLife Partnership.
• PPRM Internal Benefits Program.
• Paid Family Leave/Paid Parental Leave.
• PTO and Sick Time.
• Float Holidays (You pick your holidays).
• Bereavement Leave.
• And More!

COVID-19 Protocol: Vaccination against COVID-19 will no longer be a condition of employment. However, all Health Center/Patient or Community Facing Employees, must have the COVID vaccine or wear a mask at all times beginning November 1st. Proof must be uploaded upon hire. You will upload a picture or pdf of your vaccination card(s) prior to your start date.

Flu Protocol: All employees working directly with patients, the community or working in a health center will be required to have the flu shot or wear a mask during patient/community contact or while in the health center from November 1 - April 30 each year (Flu Season). Proof must be uploaded upon hire. You will upload a picture or pdf of your vaccination card(s) prior to your start date.

Background Check Required:

Planned Parenthood of the Rocky Mountains is an equal employment opportunity employer and is committed to maintaining a non-discriminatory work environment, and does not discriminate against any employee or applicant for employment on the basis of race, color, religion, sex, national origin, age, disability, veteran status, marital status, sexual orientation, gender identity, or any other characteristic protected by applicable law.

About Us:

Planned Parenthood is committed to creating a dynamic work environment that values diversity, equity, inclusion, respect, integrity, customer focus, and innovation. We are committed to creating a welcoming space for all people on our staff, in our health centers, and in our community. We do this by tending to the team, respecting and honoring all people, jumping in, trying and learning, caring for our business, and returning to our mission. Learn More

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