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Senior Coding Specialist

Primary Purpose: The primary purpose of the Senior Coding Specialist at Valera Health is to ensure the accuracy, completeness, and compliance of medical coding for patient records. This role involves analyzing clinical documentation, assigning appropriate codes for diagnoses and procedures, and collaborating with healthcare providers to optimize coding practices. The Senior Coding Specialist will also provide mentorship to junior coders, contribute to process improvements, and support the organization in maintaining high standards of data integrity and regulatory compliance.

Job Duties:

Perform internal audits as necessary including:

i) Review patient chart documentation for accuracy, coding compliance, and process adherence.

ii) Conducts complete and timely comprehensive audits with the ability to consistently meet coding standards of 90% accuracy and provide coding and documentation education

iii) Performs pre-and post-billing chart reviews to ensure the clinical documentation provides evidence of compliance with coverage requirements, Valera Health policy, and regulatory requirements including evaluation and management, and treatment rendered by VH providers.

Ability to research, apply, and keep abreast of all Valera Health policies/procedures, local/state/federal laws/regulations, and serve as a resource to care center locations/divisions in these areas.
Communication and coordination of provider education sessions and written summaries.
Keep abreast of applicable policies and regulations.
Administrative - team meetings, attend routine meetings with the Compliance Committee as needed, report findings as necessary, and demonstrate the Company's Mission, Vision, and Values through both professional behavior and job performance on a day-to-day basis to meet all expectations of the position.
Communicate with the Compliance/ Security Officer as needed any reportable findings or matters identified during the audit that would put the Company at risk.
Communicates and informs the care center locations/divisions and leadership of audit findings and corrective action plans.
Prepares accurate, concise, and timely written executive summary of findings and coordinates all provider education sessions.
Provides feedback to the Compliance Officer and Director of Revenue Cycle Management and other Valera Health departments regarding recommended revisions or updates to Valera policies, education opportunities, and documentation system enhancements.
Adheres to all Valera’s policies and procedures, the Code of Conduct, the Employee Handbook, the mandatory Ethics and Compliance, and HIPAA privacy and security programs.
- Associate's or Bachelor's degree in Health Information Management, Medical Coding, or a related field preferred but not required.
- Current certification as a Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent.Participates in special projects and performs other duties as assigned.

Qualifications:

Education and Certification or a combination of equivalent experience:

Associate's or Bachelor's degree in Health Information Management, Medical Coding, or a related field preferred but not required.
Current certification as a Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent.Experience:
A minimum of 5 years of coding experience in a healthcare setting, with a focus on mental health services preferred.
Demonstrated experience in coding complex medical cases and using ICD-10-CM, CPT, and HCPCS coding systems.

Technical Skills:
Proficient in using electronic health record (EHR) systems and coding software.
Strong knowledge of coding guidelines, medical terminology, anatomy, and physiology.
Familiarity with regulatory requirements & compliance standards related to medical coding.

Analytical Skills:
Ability to interpret and analyze clinical documentation and patient records accurately.
Detail-oriented with a high level of accuracy in coding and documentation.
Communication and Interpersonal Skills:

Excellent written and verbal communication skills:

Ability to work collaboratively with healthcare providers, clinical staff, and administrative teams.

Strong mentoring and training skills to support the development of junior coding staff.

Physical Demands:
Occasional (0-40%) / Frequent (41-71%) / Constant (72-100%)

Constant computer work which may require repetitive motion, prolonged periods of sitting, and sustained visual and mental applications and demands.
Occasional lifting, bending, pulling, collating, and filing, some of which could be heavy (>10 lbs).
We hire people from all backgrounds because that’s what it takes to build a team that can reach and support those in need of high-quality behavioral healthcare. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law.

This job posting/description is intended to convey information essential to understanding the scope of the position. It is not intended to be an exhaustive list of skills, efforts, duties, or responsibilities associated with the positions.

*In compliance with all states and cities that require transparency of pay, the compensation for this position has a guarantee of no less than $58,000.00 to $65,000.00 annually. Note wages may vary based on license level, productivity, experience, location, and skills.

Benefits include but not limited to:

Health, Vision & Dental Insurance
401k through the Standard
Paid Time Off
Short Term Disability
Life Insurance
Office Equipment
Many more

Be part of our mission!

We are very proud of the work that we do and it takes a great team to make it happen! If you are interested in one of our open positions, we’d love to start the conversation.

We hire people from all backgrounds because that’s what it takes to build a team that can reach and support those in need of high-quality behavioral healthcare. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law.

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