Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health. Occ Summary The Medical Coder Specialist will have frequent and daily interactions with internal and external clients, including but not limited to physician and non‑physician surgical providers. Responsibilities include primary diagnosis and procedural coding for the designated major surgical specialty areas and other major procedural areas, including capture of applicable Physician Quality Reporting System (PQRS) and reconciliation of all surgical cases performed at each hospital where applicable. The medical coder specialist focuses their work on the detailed physician surgical chart abstraction as well as being an immediate liaison to documentation improvement and optimization of physician coding practices for compliance and revenue purposes for the providers in these areas. Surgical abstraction coding is defined as identification of codes based solely on the source documentation for CPT and ICD‑10‑CM, respectively. Work Performed Primary code from final surgical/procedural operative reports signed by the provider. Review complex medical records and accurately code primary/secondary diagnoses and procedures using ICD‑10‑CM and/or CPT coding conventions. Maintain thorough understanding of anatomy, physiology, medical terminology, disease processes and surgical techniques through participation in continuing education programs to apply ICD‑10‑CM and CPT‑4 coding guidelines to inpatient and outpatient diagnoses and procedures. Correlate information from approved supporting clinical documentation, not limited to pathology, radiology, and other physician consultations after review by the attending physician. Provide education and training to physicians and other providers on coding and clinical documentation. Consult with and educate/train physicians on coding practices and conventions to provide detailed coding information. Communicate with nursing and ancillary services personnel for needed documentation for accurate coding. Provide real‑time feedback to surgical/procedural providers regarding proper coding and clinical documentation of services performed. Engage in provider/department contact and education as the primary liaison for clarification of documentation and coding for defined surgical operative cases, including documentation deficiencies. Mentor and assist in the training of other coders within the department. Participate in the development of coding policies and procedures as identified. Coordinate and mentor the work of designated coding employees to ensure quality and quantity of work performed through regular audits. Assist with research and development of presentation materials for continuing education programs for physicians in their areas of specialization. Interact with and provide high‑level analysis of trends to management, Revenue Managers and others about coding‑related issues. Research and identify trends in unbilled accounts. Contact appropriate personnel for clinical documentation inefficiencies. Coordinate quality reporting measures with providers and revenue managers/management (PQRS). Collaborate with appeal and edit coders for expedient resolution of accounts. Use authorized electronic media/systems for physician and non‑physician clinician documentation, coding abstraction for each surgical procedure, and review of CCI edits, LCD and NCD coverage. Perform other related duties incidental to the work described herein. Knowledge, Skills and Abilities Extensive knowledge of coding surgical procedures and applicable modifiers in a multi‑specialty setting. Understand and apply appropriate Center Medicare Services guidelines to coding. Advanced ICD‑10‑CM & CPT‑4 coding conventions. Strong grasp of anatomy, physiology, and medical terminology. Extensive DRG/APC reimbursement knowledge. Familiarity with coding software. Effective written and verbal communication skills. Data entry competency / CRT. Level Characteristics Code and abstract from surgical operative notes while providing the primary communication with specialty surgical providers in the health system. Minimum Qualifications Bachelor's degree in medical record administration or an associate degree in medical record technology or one‑year coding diploma or courses in medical terminology, anatomy & physiology with extensive training in coding. Experience Requires four years of coding experience, with at least two of those years in surgical abstraction (physician or medical group in multi‑specialty surgical practices such as cardiothoracic surgery, neurosurgery, general surgery, orthopedics, etc.). Degrees, Licensures, Certifications Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) or Certified Professional Coder (CPC). Equal Opportunity Employer Statement Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status. Essential Physical Job Functions Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department. #J-18808-Ljbffr