Specialty Physician Coder

Specialty Physician Coder | Onsite | Fountain Valley CAWhat You'll DoReview and analyze specialty coding and billing for charge processing. Review and accurately code office, hospital, and surgical/procedure services for reimbursement. Ensure accurate and compliant medical coding for inpatient and outpatient services, diagnostic tests, and other medical services rendered to patients. Work with the Coding Compliance Manager on discovered coding trends, irregularities, and needed action items. Achieve productivity standards as established by management, Achieve quality standards as established by management. Analyze and interpret medical information in the medical record and assign and sequence the correct ICD-10-CM, CPT, and/or HCPCS codes according to established coding guidelines. Review and natively code surgical operative and/or procedure reports. Follow established workflow for working claim denials in the Follow-Up work queues and identify opportunities for billing and coding improvements. Participate in developing, implementing, and reviewing programs for coding compliance monitoring, benchmark comparisons, organizational policies and procedures, and physician clinical documentation improvement programs. Work in the Follow-Up and Claim Edit work queues and analyze denial trends for optimization opportunities. Provide ongoing and frequent communication and education to providers to maximize coding compliance and reimbursement. Follow Coding Compliance department branding standards when communicating with clinical partners and fellow business center teams. Work collaboratively with Physician Billing Services Insurance and Customer Service Representatives to solve billing and coding issues. Perform monthly coding change report analysis and oversight on provider coding change trends and communicate and educate providers as needed. Work weekly Missing Charge Reports to identify missed billable charges and maximize reimbursement. Organize, attend, and participate in specialty provider meetings. Prepare presentation materials for meetings. Document meeting minutes. Follow up on important action items and decisions from meetings and report to the Coding Compliance Manager. Take responsibility for various projects as assigned by management. Perform additional and miscellaneous duties as requested by the management team within the scope of knowledge and ability. Other duties as assigned. What We Need From YouRequired Education: High School Diploma or GED. Required Certifications & Licensure: AAPC – Certified Professional Coder (CPC) OR AHIMA – Certified Coding Specialist (CCS). Required Skills & ExperienceThree (3) years of experience working in a hospital or physician’s office as a medical coder and interacting with physicians. One (1) year of experience as a specialty coder in one of the following specialties: Cardiology, Gastroenterology, Medical Hematology/Oncology, OBGYN, Pulmonology, General Surgery, Radiation Oncology Proficient in Microsoft Office Suite, Proficient in Epic software. Excellent communication skills with the ability to communicate information accurately and clearly. Ability to manage interpersonal relationships and effectively communicate with clinical partners and fellow business center teams. Ability to provide excellent customer service and address a moderate amount of incoming email and phone calls. Collaborative team player with the ability to adapt to the ever-changing healthcare environment. Professional demeanor at all times. Ability to handle complex and confidential information with discretion. Strong work ethic; honest and dependable. Strong personal time management skills. Expert knowledge of ICD-10, CPT, and HCPCS. Strong knowledge of medical terminology, anatomy, and physiology. English – Read, Write, Speak. A Few Things to KnowEpic software experience. Specialty coding certification in a relevant specialty area, including but not limited to: AAPC – Certified Cardiology Coder (CCC); AAPC – Certified Gastroenterology Coder (CGIC); AAPC – Certified General Surgery Coder (CGSC) One (1) year experience as a specialty coder in one of the following specialties: Cardiology; Gastroenterology; Medical Hematology/Oncology; OBGYN; Pulmonology; General Surgery; Radiation Oncology Key Technical Requirements: EPIC; ICD-10 Coding; CPT Coding; HCPCS Coding; Medical Terminology; Anatomy and Physiology; Claim Denials Management; Healthcare Revenue Cycle Knowledge; Provider Education and Coding Compliance Work EnvironmentWorks under the direction of the Coding Compliance Manager. Collaborates with physicians, clinical partners, business center teams, Physician Billing Services Insurance Representatives, and Customer Service Representatives. Responsible for maintaining confidentiality, coding accuracy, productivity standards, and quality standards.