Physician Coding Specialist

I. JOB SUMMARY/RESPONSIBILITIES
Performs review of physician and other health care provider services by QMC and QEC providers to ensure services are coded with appropriate CPT and ICD-9 codes. Conducts education, training, and continuously monitors QMC and QEC providers related to PATH guidelines, coding and documentation of professional services rendered, in accordance with government, insurer, and other regulatory agency standards.  Effective October 2014, ICD-10 codes shall be required.

II. TYPICAL PHYSICAL DEMANDS:
Essential: sitting, stooping/bending, finger dexterity, seeing, hearing, speaking, lifting, and carrying usual weight of 5 pounds, repetitive arm/hand motions, static gripping of an object for prolonged periods, frequent gripping of an object.  Occasional: standing, walking, kneeling, climbing stairs, squatting, twisting body, lifting weight up to 10 pounds, pushing/
pulling usual weight of 2 pounds up to 5 pounds, reaching above, at and below shoulder level.  Operates computer, calculator, and telephone.

III. TYPICAL WORKING CONDITIONS:
Not substantially subjected to adverse environmental conditions. 

IV. MINIMUM QUALIFICATIONS:
A.  Education/Certification and Licensure:
1.  Certification as an Outpatient Physician Coder (CPC) or Certified Coding Specialist -Physician based (CCS-P).
2. Knowledge of CPT-4 and ICD-9 coding.  Effective October 2014, knowledge of ICD-10 shall be required.
3. Knowledge of medical terminology and abbreviates.

B.  Experience:
1.  Broad based knowledge of services provided to patients in both inpatient and outpatient settings.
2.  Two (2) years experience in physician coding preferred.
3.  Knowledge of computerized billing system preferred.
4.  Knowledge of billing regulations, PATH guidelines, insurance coverage limitations and managed care protocols preferred.
5.  Experience providing one-on-one feedback to physicians and other health care providers preferred.