Coder Physician

Omega Healthcare Management Services • Boca Raton, FL

7d • Remote

About The Position

Under limited supervision, the Coder Physician reviews medical records and performs coding on all diagnoses, procedures, DRG/APC, and charge codes. The Coder Physician uses the most accurate codes for reimbursement purposes, research, epidemiology, statistical analysis outcomes, financial and strategic planning, evaluation of quality of care, and communication to support the patient’s treatment. The Coder Physician will be charged with maintaining the confidentiality of patient records and procedures.

Requirements

• Successful completion of an AAPC or AHIMA-approved Coding Certificate Program
• a minimum of two to four years of current production coding experience in both acute care and profee.
• Credentialed as a professional coder (CPC, CCS, or equivalent)
• a minimum of 2 years of experience in a multi-specialty practice.
• Proficiency in medical terminology, anatomy, and physiology, with a strong understanding of coding guidelines and regulations.
• Experience with electronic health record (EHR) systems, particularly Epic, and coding software.
• Excellent attention to detail and accuracy in coding and documentation, ensuring high-quality patient records.
• Strong analytical and problem-solving skills, especially in handling appeals and denials, with a track record of successful resolutions.
• Ability to work independently, manage multiple tasks, and prioritize effectively in a fast-paced healthcare environment.
• Exceptional communication and interpersonal skills, fostering positive relationships with healthcare professionals and insurance companies.
• Willingness to stay updated with industry changes and a commitment to continuous professional development.
• A strong sense of ethics and a commitment to maintaining patient confidentiality at all times.
• A collaborative mindset, contributing to a positive and supportive team culture within our practice.
• Knowledge of coding convention and rules established by the AHIMA , American Medical Association (AMA), the American Hospital Association (AHA) and the Center for Medicare and Medicaid (CMS), for assignment of diagnostic and surgical procedural codes.
• Knowledge of JCAHO, coding compliance and HIPAA HITECH standards affecting medical records and the impact on reimbursement and accreditation.

Nice To Haves

• N/A

Responsibilities

• Responsible for abstracting, coding, sequencing and interpreting the clinical information from inpatient, outpatient, emergency department, pro fee, and clinical medical records.
• Responsible for the assignment of correct principal diagnoses, secondary diagnoses and principal procedure and secondary procedure codes with attention to accurate sequencing.
• Utilizes technical coding principals and DRG/APC reimbursement expertise to assign appropriate codes.
• Abstracts and codes pertinent medical data into multiple software programs and/or encoders.
• Follows official coding guidelines to review and analyze health records.
• Maintains compliance with both external regulatory and accreditation requirements, and with State and Federal regulations.
• Extracts pertinent data from the patient’s health record and determines appropriate coding for reports and billing documents.
• Identifies codes for reporting medical services, procedures performed by physicians.
• Enters codes into various computer systems dependent upon the various clients.
• Track and document productivity in specified systems, maintain productivity levels as defined by the client.
• Maintain 95% quality rating
• Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.
• Review and assign accurate medical codes for diagnoses, procedures, and services, ensuring compliance with ICD-10, CPT, and HCPCS guidelines.
• Collaborate with physicians and healthcare professionals to clarify and verify medical documentation, enhancing the accuracy of our records.
• Conduct regular audits of medical records to identify coding errors and areas for improvement, contributing to our practice's continuous quality improvement.
• Handle appeals and denials, investigating the root cause, and taking necessary actions, including communication with payers and building appeal packets.
• Stay updated with coding regulations and industry trends, attending relevant training sessions to enhance your expertise.
• Provide mentorship and guidance to less experienced coders, fostering a culture of knowledge sharing and continuous learning.
• Maintain organized and secure coding records, ensuring data integrity and patient confidentiality at all times.
• Assist in developing and implementing efficient coding policies and procedures, contributing to the overall operational excellence of our practice.
• Collaborate with the billing team to ensure timely and accurate billing processes, minimizing denials and maximizing revenue.
• Act as a liaison between our practice and insurance companies, resolving coding-related issues and maintaining positive relationships.

Benefits

• The employee will have access to the Omega systems set forth in the “Standard Field Employee” profile.
• Microsoft Office
• ADP
• Oracle
• Reviewmate
• E1- All Field Employees
• Standard Employee
• Standard Coder and Client Access based on client needs.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed