Senior Professional Coder - FT - Day - Physician Professional Coders Remote

Capital Health (US)

1d•Remote

About The Position

Responsible for performing highly complex CPT, HCPCS, and ICD-10-CM coding for professional claims billed by Capital Health Medical Group (CHMG) for hospital and outpatient procedures. Provides expert-level coding, supports provider documentation improvement, resolves complex billing issues, conducts coding reviews of staff, and serves as a resource and mentor to coding staff. Provides assistance and support to the manager as it relates to time management, delegation of workflow tasks and responsibilities, knowledge of industry guidelines, laws and regulations. Reviews procedure documentation for accurate assignment of ICD-10-CM diagnosis, current procedural terminology (CPT-4) codes and modifiers. Ensures appropriate coding of evaluation and management (E&M) services when applicable.

Requirements

High school diploma or equivalent.
Certified Professional Coder-Apprentice (CPC-A), Certified Professional Coder (CPC), or Certified Coding Specialist-Physician (CCS-P) certification required.
Three years' experience in physician coding role with surgical coding experience required using ICD-10-CM, CPT-4 and HCPCS.
Physician coding and Training certification.
Proficient with Microsoft applications to include Outlook, Word, Excel, PowerPoint.
Medical Terminology, Anatomy and Physiology, or Pathophysiology knowledge.
Ability to work in environment using multiple EMR systems.
Ability to work collaboratively with others as well as independently.

Nice To Haves

Associate's degree in health information management preferred.

Responsibilities

Assists in management of professional coding team workflow to assure timely and efficient coding.
Provides second level scrutiny of procedural documentation as well as code assignment to optimal and compliant coding.
Shares expertise in professional coding with team members to resolve complex coding issues and build skill level and proficiency.
Conducts internal coding reviews to ensure accuracy, compliance, and documentation sufficiency.
Contacts and collaborates with appropriate personnel for documentation insufficiencies to expedite resolution of accounts.
Meets or exceeds departmental accuracy and productivity standards.
Fosters teamwork and collaboration.
Collaborates with CHMG providers to explain coding requirements and documentation standards.
Ensures compliance with national coding guidelines and Capital Health's policies for complete, accurate and consistent coding resulting in appropriate reimbursement and data integrity.
Performs coding duties and reviews CCI edits, MUE edits, LCD and NCD coverage before chart finalization.
Assists with onboarding, training, and mentoring of new staff.
Supports system upgrades, coding tool enhancements, EMR changes, and new specialty rollouts.
Assists in management of professional coding pre-bill edits timely to ensure minimal days in DNFB.
Supports continuous process improvement efforts to enhance coding outcomes
Maintains level of expertise through continuing education.
Performs other duties as assigned.