Function: | |
| The Certified Coding Specialist (CCS) is responsible for accurate and compliant coding, charge capture review, claims support, and documentation validation for behavioral health services within a Certified Community Behavioral Health Clinic (CCBHC). This position ensures adherence to federal, state, Medicaid, Medicare, and commercial payer guidelines while supporting revenue integrity and compliance initiatives. The Coding Specialist works collaboratively with providers, billing staff, compliance personnel, and clinical leadership to improve coding accuracy, reduce denials, and support optimal reimbursement for behavioral health and integrated care services. | |
Organizational duties & responsibilities: | |
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Essential Duties and Responsibilities: | |
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Working conditions/environment: | |
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minimum job requirements: | |
Education: | High School Diploma or GED required. Associate Degree in Business or Medical Billing and Coding field preferred; work experience or other education may be considered in lieu of degree. |
Experience: | Minimum of two (2) years of supervisory or lead experience in medical coding, billing, or health information management required. Experience with electronic health record (EHR) systems and revenue cycle platforms is required. Minimum of three (4) years of coding experience in behavioral health, mental health, substance use treatment, or healthcare setting preferred. Experience working in a CCBHC, FQHC, CMHC, or integrated behavioral health setting preferred. |
Specific Skills andrequirements: | Must be at least 21 years of age. Excellent organizational, analytical, and communication skills. Strong knowledge of ICD-10, CPT, HCPCS, Medicaid, Medicare, and behavioral health billing requirements. Knowledge of SAMHSA CCBHC requirements and documentation standards. Technical requirements include proficiency with Microsoft Word, Excel, PowerPoint, and any other applications used by the organization or regulatory agencies. Must also have ability to interface well with all departments in a highly professional manner. Ability to understand and relate to the needs of clients from diverse backgrounds. Ability to read, write and converse in English. Successful completion of a pre-employment drug screen. Successful completion of a background screening. Successful completion of a TB skin test or proof of a negative chest x-ray or other documentation. |
Specialized Licenses or training: | Certified Coding Specialist (CCS), CPC, or equivalent coding certification required. Certified Professional Medical Auditor (CPMA), Certified Coding Auditor (CCA), or equivalent auditing certification preferred. Successful completion of Excellent Foundations Maintain 20 hours of annual training |
Physical Requirements: | |
| The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee is regularly required to stand, sit, walk, talk, hear, reach with hands and arms, and use hands to finger, handle, and feel. This employee is also regularly required to use a computer keyboard and mouse. The employee is occasionally required to stoop, kneel, crouch, and climb stairs. The employee must occasionally lift and/or move up to 10 pounds or more. Specific vision abilities required by this job include close vision, distance vision, and peripheral vision. | |
Supervisory REquirements: | |
| N/A | |
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