Physician Practice Coder

BMC Software

1d•$24 - $34

About The Position

The Physician Practice Coder reviews physician medical records and charge sessions to accurately code diagnoses, procedures, modifiers, and billed services. The role conducts chart audits, reviews documentation and signatures, and helps ensure accurate coding and charge capture. It also analyzes coding-related claim denials, investigates root causes and recurring patterns, and works with revenue cycle stakeholders and providers to identify coding, documentation, workflow, or system improvements. The coder follows applicable coding, payer, Medicare, Medicaid, and regulatory guidance; maintains productivity and coding credentials; researches coding issues; responds to coding questions; and provides coding updates. The position also follows hospital infection control and safety procedures, maintains confidentiality and HIPAA compliance, and adheres to BMC’s RESPECT behavioral standards.

Requirements

Associate degree or direct work experience equivalent to at least two years.
CPC or CCS certification.
Two to five years of experience in a multi-specialty physician coding environment, including coding, compliance, and billing processes.
In-depth knowledge of medical terminology, ICD-10-CM, and CPT-4.
Basic knowledge of human anatomy, physiology, and pathology.
Strong knowledge of health records, computerized billing and charging systems, Microsoft applications, data integrity, and processing techniques.
Excellent organization, multitasking, prioritization, follow-through, and time-management skills.
Accuracy and attention to detail.
Ability to solve problems using job knowledge and current policies and procedures.
Ability to work cooperatively with healthcare delivery team members and staff, manage frequent interruptions, adapt to changes in workload and schedule, and respond promptly to urgent requests.
Ability to maintain strict confidentiality of personal and health-sensitive information and ensure HIPAA compliance.
Ability to analyze coding-related claim denials, identify underlying causes, and recommend appropriate coding corrections.

Responsibilities

Review patient medical records and abstract diagnoses and procedures.
Code diagnoses, procedures, and appropriate modifiers using ICD-10-CM, CPT-4, and HCPCS classification systems.
Use encoding systems, coding aids, reference materials, and applicable official and regulatory guidelines to ensure accurate coding.
Sequence diagnoses, procedures, and complications according to applicable ICD-10-CM, CPT-4, UHDDS, payer, Medicare, and Medicaid guidelines.
Consult with the CDCI team to request clarification from physicians or other appropriate medical staff.
Maintain departmental productivity standards and yearly coding credentials.
Review and respond to coding questions, research coding issues, and provide continual coding updates.
Ensure billed services are accurately coded and perform random chart audits.
Review charts for documentation and signatures.
Analyze coding-related claim denials by reviewing denied claims, physician records, charge sessions, payer information, and applicable guidelines.
Identify denial trends and perform root cause analysis to find opportunities for coding, documentation, workflow, or system improvements.
Determine appropriate coding corrections and recommend resolutions to coding-related denials.
Follow hospital infection control and safety procedures, protect confidential health information, comply with HIPAA, and adhere to BMC’s RESPECT behavioral standards.
Perform other duties as needed.