Pro-Fee Oncology Physician Coder - CA Residents Only

• 100% remote but candidate must reside in California
• These are full-time opportunities
• Full Benefits - Health/Dental/Vision/Life/AD&D/FSA
• Basic Term Life Insurance and accidental death insurance
• 401(k) contributions 
• Client to provide Codify
• Equipment supplied

• CPC or CCS required 
• CHONC preferred
• Minimum of 3 years of current experience in a hospital or physicians office as a medical coder
• Expert knowledge of ICD10-CM, CPT, and HCPCS
• EPIC software experience required
• Proficient with Microsoft

Purpose Statement / Position Summary

Under the direction of the Coding Compliance Manager, the Pro-Fee Oncology Physician Coder will play a key role in reviewing and analyzing billing and coding for charge processing, specifically with Hematology/Oncology.  This role will be responsible for reviewing and accurately coding office, hospital, and surgical procedures for reimbursement, as well as ensuring accurate and compliant medical coding for both inpatient and outpatient services, diagnostic tests, and other medical services rendered to each patient.

 Essential Functions and Responsibilities of the Job

• Proficient in Microsoft Office suite
• Proficient in Epic software
• Possess analytical skills
• Possess critical thinking and problem-solving skills
• Solid understanding of the health care revenue cycle
• Strong communication skills with the ability to communicate information accurately and clearly
• Provide excellent customer service
• The ability to manage interpersonal relationships and effectively communicate with clinical partners and fellow business center teams
• Detail oriented
• Strong work ethic, honest, and dependable
• Collaborative team player with the ability to adapt to the ever-changing healthcare environment
• Professional demeanor at all times
• Maintain patient confidentiality
• Maintain a safe and orderly work area
• Personal time management skills – the ability to organize, prioritize, and multitask
• Be at work and be on time
• Follow company policies, procedures and directives
• Interact in a positive and constructive manner
• Prioritize and multitask

Essential Job Outcomes 

• Achievement of productivity standards as established by management.
• Achievement of quality standards as established by management. In adherence with standard work, analyze and interpret medical information in the medical record and assign and sequence the correct ICD-10-CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient and/or outpatient medical records according to established coding guidelines.
• In adherence with standard work, follow established workflow for working claim denials in the Follow-Up work queues and identify opportunities for billing/coding improvements. Participate in developing, implementing, and reviewing programs for coding compliance monitoring, criteria for benchmark comparisons, organizational policies and procedures, and physician clinical documentation improvement programs. Optimization opportunities include, but are not limited to, work in the Follow-Up and Claim Edit work queues and analyzing denial trends.
• In adherence with standard work, provide ongoing and frequent communication/education to MCMF providers to maximize coding compliance and reimbursement. Follow Coding Compliance department branding standards when communicating with clinical partners and fellow business center teams, and work collaboratively with Physician Billing Services Insurance and Customer Service Representatives to solve billing and coding issues. Perform monthly coding change report analysis/oversight on provider coding change trends and communicate/educate providers, as needed.
• In adherence with standard work, work weekly Missing Charge Reports to identify missed billable charges to maximize reimbursement.
• In adherence with standard work, take responsibility for various projects as assigned by management, and perform any additional/miscellaneous duties (not inclusive of job description) as requested by the management team within the scope of knowledge/ability.
• “Other duties as assigned” 

Education

• High School diploma or GED required;
• CPC, CCS or equivalent certification required