Scope of Duties:

The Dermatology Coding Specialist provides guidance in accordance with state, Federal, and payer guidelines and is responsible for accurate coding, auditing, and training. The specialist works along with the coding team to provide the BEST-IN-CLASS service to our clients.

• Read and abstract physician office notes and operative notes to apply correct ICD-10-CM, CPT®, HCPCS Level II, and modifier coding assignments.
• Work with the AR team to address and provide resolution for coding related denials including appeal cover letter creation and review.
• Assist with E/M audits using the 2021 evaluation and management (E/M) guidelines for new and established office and outpatient services, as well as E/M coding based on 1995 and 1997 documentation guidelines.
• Collaborate with the offshore coding team to perform yearly provider/client audits including ongoing monitoring and education.
• Research coding questions and provide supporting resource material for Account/RCM Managers.
• Code and audit surgical procedures including excisions, closures, and MOHS.
• Communicate with providers via video/phone/email to assist them with coding challenges and questions.
• Create coding training documents/white papers/PowerPoint presentations for staff and provider education.
• Provider documentation improvement assessments.
• Assist with RAC/TPE reviews as directed.
• Work on special projects related to dermatology services and procedures.

Job Requirements:

• High School Diploma
• Certified Dermatology Coder (CPC-D, CDC, credential is current)
• Knowledge of ICD-10 and CPT coding guidelines in accordance with federal and payer guidelines, including use of modifiers, NCCI edits, CMS LCD (Local Coverage Determination) and CMS Articles
• Knowledge of insurance reimbursement practices and overall/general understanding of revenue cycle management (RCM)
• Excellent customer/client service skills
• Strong computer skills, able to use and navigate in excel, basic formulas
• Ability to establish and maintain effective working relationships with physicians and colleagues
• Able to work effectively with colleagues as team members and to communicate clearly
• Follows directions as given by supervisor
• Self-Motivator and able to work independently
• Ensures work product is accurate and complete
• Strong communication skills to provide clear instructions and ability to maintain professionalism in both written and oral form
• Excellent organizational skills, including prioritization
• Critical thinking skills
• Engages in all time sensitive tasks with appropriate level of urgency
• Ability to maintain strict confidentiality in accordance with HIPAA regulations
• Must maintain a high level of integrity and honesty
• Ability to manage multiple tasks effectively
• Performs related work as required

Physical Requirements:

• Sitting for extended periods of time
• Work performed in a remote environment
• Must have adequate hearing and speaking ability to communicate with co-workers and clients over the phone or video platform