Medical Coding Specialist

Why work for Balboa:

• Balboa Nephrology is the largest kidney care practice in California and participates in a national Medicare program focused on value-based care.
• Through our joint venture with Evergreen Nephrology we are a growing organization with opportunities for professional and personal growth.
• We will help you grow in your leadership experiences while learning the new value-based care world.
• Comprehensive benefits package that includes medical, dental & vision on the 1st of the month 30 days after hire.
• Employer contribution of up to 10% of annual pay for your 401K.
• Generous paid time off plus 8 paid holidays, a birthday float day off and a mental health day!
• Company paid life insurance.
• Join a fast-growing field - employment of medical and health services managers is projected to grow 32 percent from 2020 to 2030, much faster than the average for all occupations.
• Voted Top Workplace of San Diego 2017 and 2020 - 2023!
• Hybrid position after successful completion of training.
• Qualifies for quarterly performance incentive.

Our Values: Patient-centered I Accountability I Respect I Innovation I Data-Driven

Our Mission: to consistently deliver superior care – Balboa Care – to every patient with kidney disease.

Work location: Hybrid

• Works out of Executive Square office in La Jolla, San Diego, CA. Eligible for hybrid schedule upon successful completion of training.

Position Summary:

Medical Coding Specialist reviews charges and documentation to ensure correct ICD and CPT/HCPCS codes for nephrology based services including dialysis, office based, dialysis access at outpatient surgery center, and hospital based services. Specialist helps to educate providers, works coding denials, projects, and participates in denial mitigation and performance improvement efforts.

Pay Rate: $26.00 - $29.00/hour, depending on experience

Essential Duties and Responsibilities:

• Reviews clinical documentation to ensure appropriate ICD, CPT, HCPCS codes.
• Queriers providers when assistance is needed for proper identification of codes for diagnosis or procedures.
• Audits charts as necessary and reports findings.
• Provides coding outreach and education to providers.
• Provides input on existing charge review edits and proposes revisions.
• Assists in reviewing escalated coding denials.
• Supports and actively participates in process improvement initiatives.
• Assists with other duties to support the revenue cycle process and Balboa’s core values.

Required Qualifications:

• 2 years recent physician based coding experience.
• Active certification as a Certified Professional Coder (CPC) from AAPC or Certified Coding Specialist (CCS) from AHIMA.
• Understanding of medical revenue cycle process and coding billing guidelines.
• Knowledge of payor correct coding principles and CCI edits.
• Proficiency with Microsoft Excel, Word, PowerPoint, Outlook and Teams. Ability to type at least 30 wpm.

Preferred Qualifications:

• Nephrology coding experience
• Epic experience

Education:

• High School graduate required.

Required Skills:

• Excellent verbal and written communication.
• Ability to interpret, adapt and apply guidelines and procedures.
• Ability to establish and maintain effective working relationships with providers, medical staff and coworkers.

• Demonstrates accuracy, organizational and problem-solving skills. Looks for ways to improve and promote quality and monitors own work to ensure quality is met
• Maintain confidentiality.
• Work independently, prioritize work activities and use time efficiently.

Other Considerations:

• Background check required
• Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
• Supervisory duties – no
• Status – full time
• Work Environment – This position operates in a professional office environment and routinely uses standard office equipment such as laptop, computer, mouse, and photocopier.
• Physical Demands – While performing duties, the employee is regularly required to talk, hear, read, write, type and respond. Specific vision abilities required by this job include close vision and ability to adjust focus. This position requires the ability to open cabinets at various levels, bend, stand, stoop and drive as necessary.

Language Skills

While performing duties, the employee is regularly required to talk, hear, read, write, type and respond in English and understand clinical/medical vocabulary written and spoken.

Vision Requirements

Vision requirements include close vision, ability to adjust focus, and see color.

Physical Demands

Physical requirements may vary slightly and should be reviewed with your manger. In general, this position requires the ability to lift up to 35 pounds unassisted; ability to stand for extended periods of time and to perform repetitive stooping, walking, stretching, reaching and some sitting; ability to use full range of body motions required to lift patients, wear a lead apron, and lift and move supplies.

Work Environment

Job required tasks routinely involve a potential for mucous membrane or skin contact with blood, body fluids, tissues or potential spills or splashes. Use of appropriate personal protection measures is required for every healthcare provider in these positions. Require to routinely use standard office equipment such as laptop, computer, mouse, and photocopier.

About Balboa United

Beginning in 1973, Balboa has grown from two physicians to a comprehensive nephrology team of 52 board certified physicians and 8 advanced practitioners. On January 1, 2018, Balboa Nephrology Medical Group (BNMG) launched Balboa United, a full-service medical practice management services organization. From one small office, BNMG now has 24 clinical offices throughout San Diego, Imperial, Orange and Riverside counties. In addition to office and hospital-based patient care, Balboa physicians manage the dialysis treatments of approximately 4,500 patients at 88 dialysis centers and conduct Nephrology based clinical research at 6 centers throughout Imperial and San Diego counties (California Institute of Renal Research).

• EEO Statement Balboa United is an equal opportunity employer and makes employment decisions on the basis of merit. We want to have the best available person in every job. Our Company policy prohibits unlawful discrimination based on race, color, creed, religion (including religious dress & grooming), sex (including pregnancy, childbirth or related medical conditions), gender (including gender identity and gender expression), marital status, registered domestic partner status, military status, age, national origin or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), genetic information, sexual orientation, or any other basis protected by applicable federal, state, or local law. We also prohibit unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has or is perceived as having any of those characteristics. The Company is committed to compliance with all applicable laws providing equal employment opportunities. This commitment applies to all persons involved in our operations and prohibits unlawful discrimination by any employee of Balboa United, including managers and co-workers. If you believe you have been subjected to any form of unlawful discrimination, submit a written complaint to your manager or Human Resources (HR). Your complaint should be specific and should include the names of the individuals involved and the names of any witnesses. If you need assistance with your complaint, or if you prefer to make a complaint in person, contact the Company's Human Resources Department. We will immediately undertake an effective, thorough, and objective investigation and attempt to resolve the situation.