Coding Specialist at Chimes International Limited in Baltimore, Maryland

Posted in General Business about 2 hours ago.

Type: Full-Time





Job Description:

Join Chimes - and go further to help others go far! Chimes is a not-for-profit organization that assists people with intellectual and behavioral challenges to achieve their fullest potential.Our vast array of services - educational, employment, vocational, residential, habilitative and behavioral health - are delivered through a network of national and international affiliates. This allows us to take a comprehensive, holistic approach to improving the lives of every person we serve - those who receive and reap the benefits of our innovative, responsive solutions.Compensation: $65,000-$68,000PRIMARY JOB FUNCTION(S):


  • Independently performs scheduled audits especially audits that involve receiving medical codes etc, required by the work plan and unplanned investigations
  • Provides compliance guidance to personnel
  • Answers questions and provides guidance on coding and/or billing issues
  • Works with team to determine appropriate corrective action when necessary
  • Monitors and respond to certain regulatory request
  • Represents the Compliance Department on various committees as requested
  • Generates narrative and quantitative reports concerning all activities.
  • Prepares information required for designated meetings.
  • Contributes to a work atmosphere in a manner which is positive, enthusiastic, respectful and courteous.
  • Ability to follow detailed instructions.
  • Uses technology for the completion of specified job duties and assists staff in learning to use the technology.
  • Attends work regularly according to assigned work schedule and in accordance with Agency policy.
  • Attends and participates in in-service training, staff meetings, and other activities to facilitate professional development.
  • Works cooperatively with others including staff, supervisors, administrators, co-workers, individuals served, community professionals, customers, vendors, and the public.
  • Assist with plans of correction for OHCQ site visit reports within applicable time frame(s) and ensure completion of corrective actions.
  • Provides scheduled staff training as determined by the training department.
  • Works a flexible schedule consisting of evening hours as needed.
  • Assumes other administrative duties, responsibilities and special projects as assigned
  • Ability to differentiate between CMS-1500 and UB-04 claims
  • Knowledge of Substance Abuse and Mental Health CPT and revenue codes
  • Strong familiarity with major commercial insurance plans and policy types, specifically BCBS, Aetna, Cigna, Johns Hopkins, United Healthcare, and Medicaid
  • Advance proficiency in Microsoft Office Suite, particularly Excel
  • Will be working through ICD9 and ICD10 codes
  • Must have strong working knowledge of Medical Terminology

REQUIREMENTS:Obtain Certified Investigator certification within 90 days of hireDriver's licenseEDUCATION:BA DegreeMedical Coding Certification required (CPC OR CPC-A)EXPERIENCE:

  • Professional level of knowledge of billing practices and procedures
  • In depth knowledge in the areas of Medicare and Medicaid, and commercial insurance billing regulations
  • Minimum of 4 years' experience in a healthcare compliance program, however provider payment and healthcare coding experience may be used toward experience requirement
  • Familiarity with the healthcare regulatory environment
  • Knowledge of basic coding and healthcare licensing/accreditation standards is required
  • Knowledge of multi state and federal laws and regulation with affect compliance operations

NOTE: At the discretion of the Personnel Officer, additional related experience and/or education may be substituted in lieu of the requirements specified under Education and Experience.What's in it for you? Total Rewards (For Full-Time Employees = >30 hours/week):

  • Medical, Dental, and Vision Insurance
  • Flexible Spending Accounts
  • Life Insurance
  • Disability Insurance
  • Paid Time Off
  • 403(b) with Company Match
  • Transportation Subsidy
  • Employee Recognition Programs
  • Referral Bonus opportunities
  • And More!

Want to learn more?To learn more about Chimes, and how you can achieve personal and professional growth within a purpose-driven organization, visit us at: https://chimes.org/Careers. #cmd410





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