Job Title: Specialty Physician Coder Job Location: Fountain Valley, CA Job Duration: 3 Months (possibility of extension) Payrate: $45.00 - $48.27/ hr. on w2 Job Summary:
Under the direction of the Coding Compliance Manager, the Specialty Physician Coder plays a key role in reviewing and analyzing specialty coding and billing for charge processing.
This role is responsible for reviewing and accurately coding office, hospital, and surgical/procedures for reimbursement, ensuring accurate and compliant medical coding for inpatient and outpatient services, diagnostic tests, and other medical services rendered to patients.
The Specialty Physician Coder will also collaborate with the Coding Compliance Manager to identify coding trends, irregularities, and required action items.
Essential Functions and Responsibilities:
Meet productivity standards established by management
Meet quality standards established by management
In adherence with standard work, analyze and interpret medical records and assign and sequence appropriate ICD-10-CM, CPT, and/or HCPCS codes for office, inpatient, and/or outpatient records according to established coding guidelines, including the ability to review and code surgical operative and/or procedure reports
Follow established workflows for claim denials in Follow-Up work queues, identify opportunities for billing/coding improvements, and participate in coding compliance monitoring, benchmarking, policy development, and physician documentation improvement programs
Analyze denial trends and optimize processes within Follow-Up and Claim Edit work queues
Provide ongoing communication and education to MCMF providers to maximize coding compliance and reimbursement
Adhere to Coding Compliance department communication standards and collaborate with Physician Billing Services Insurance and Customer Service teams to resolve billing and coding issues
Perform monthly coding change report analysis and communicate trends to providers as needed
Work weekly Missing Charge Reports to identify missed billable charges and maximize reimbursement
Organize, attend, and participate in specialty provider meetings
Prepare presentation materials, document meeting minutes, follow up on action items, and report to the Coding Compliance Manager
Take responsibility for assigned projects and perform additional duties as requested by management
Other duties as assigned.
Experience:
3 years of experience working in a hospital or physician's office as a medical coder, including interaction with physicians
1 year of experience as a specialty coder in one of the following: Cardiology, Gastroenterology, Medical Hematology/Oncology, OBGYN, Pulmonology, General Surgery, or Radiation Oncology
Epic software experience highly preferred.
Cardiology and Cardiac Surgery Experience:
Strong Evaluation and Management (E/M) inpatient and outpatient coding experience
Must reside in CA but can work remotely
Proof ONLY - NOT HCC/risk adjustment, ASC, or facility coding
Desire to convert to full-time employment
Experience working on denials
GI (CGIC coding certification) or OBGYN (COBGC coding certification) coding experience (1 year or more)
Knowledge, Skills, and Abilities:
Strong critical care knowledge.
Must be able to abstract chart reviews to capture all billable charges
CCC certification required
Must be knowledgeable in heart catheterizations
Expert knowledge of ICD-10, CPT, and HCPCS
Strong knowledge of medical terminology, anatomy, and physiology
Proficient in Microsoft Office
Proficient in Microsoft Office Suite
Proficient in Epic software
Strong analytical skills
Strong critical thinking skills
Detail-oriented
Ability to anticipate, research, and resolve problems with strong problem-solving skills
Strong understanding of the healthcare revenue cycle
Excellent communication skills with the ability to convey information accurately and clearly
Ability to manage interpersonal relationships and communicate effectively with clinical partners and business center teams
Provide excellent customer service and manage a moderate volume of incoming emails and phone calls
Collaborative team player with the ability to adapt to a dynamic healthcare environment
Maintain a professional demeanor at all times
Ability to handle complex and confidential information with discretion
Maintain patient confidentiality
Maintain a safe and organized work area
Strong work ethic; honest and dependable
Strong personal time management skills
Maintain regular attendance and punctuality
Follow company policies, procedures, and directives