Coding Quality Specialist 3- Anatomical Pathology
About The Position
Accurate coding is foundational to quality patient care, regulatory compliance, and the financial health of a leading academic medical center. As a Coding Specialist 3, you will play an essential role in ensuring the integrity of Anatomic Pathology and coding practices while supporting providers who deliver critical Anatomical Pathology services across the continuum of care. This fully remote opportunity is ideal for an experienced professional fee coder with a passion for Profee Anatomic Pathology. You'll leverage your expertise to review complex clinical documentation, promote coding accuracy, identify compliance risks, and help ensure appropriate reimbursement for services that directly support patient access to Anatomical Pathology.
Requirements
- High School Diploma or GED required.
- 5+ years of relevant Anatomical Pathology coding experience required.
- Certified Professional Coder (CPC) required.
Responsibilities
- Serve as a trusted resource for coding quality, compliance, and documentation integrity within Anatomical Pathology services.
- Review and validate Anatomical Pathology professional fee coding independently.
- Collaborate with providers and operational partners to maintain coding excellence across a diverse health practice.
- Demonstrate prowess in coding pathology physician services using CPT, HCPCS, and ICD-10-CM guidelines.
- Display proficiency in coding and reviewing surgical pathology specimens (CPT 88302-88309), gross and microscopic examinations, pathology consults on outside material (CPT 88321-88323), intraoperative consultations/frozen sections (88331-88332), special stains and immunohistochemistry (88312, 88313, 88341, 88342, G0461-G0462), and molecular pathology and pathology consultation services.
- Exhibit a strong understanding of pathology documentation requirements, medical necessity, and payer-specific billing guidelines.
- Resolve coding edits, denials, charge review work queues, and physician documentation inquiries related to pathology services.
- Determine when provider education or compliant clarification is warranted.
- Apply expertise related to NCCI edits, LCD/NCD policies, and payer-specific billing requirements.
- Support coding quality initiatives through charge review processes, work queue management, and ongoing coding validation activities.
- Utilize Epic, Codify and other coding resources to research and resolve complex coding questions.
- Maintain current knowledge of evolving Anatomical Pathology health coding regulations and reimbursement guidelines.
- Work with a broad range of Pathology services, including outpatient, inpatient and consultative services.
Benefits
- Medical, Dental, and Vision Insurance
- Generous Paid Time Off
- Retirement Savings
- Long-term and Short-term Disability
- Health Saving Plans, and Flexible Spending Accounts
- Certification and Education Support
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
