Coding Specialist III - Plastics/Podiatric Surgery

About this Job

MedStar Health is looking for a Coding Specialist III with experience in Plastics/Podiatric Surgery coding to join our team!

Primary Duties and Responsibilities

• Absorts and ensures accuracy of diagnosis, procedure, patient demographics and other required data elements.
• Aids in the creation of training and educational coding guidance documents for physicians and MMG Associates.
• Affords assistance in developing guidance to clinicians in optimizing dictations to promote compliance and claim to process.
• Affords assistance in the maintenance of billing, coding and editing dictionaries in the billing system.
• Consistently meets or exceeds established Quality Accuracy and Productivity standards as defined by policies.
• Contacts physician when conflicting or ambiguous information appears in the medical record. Requests diagnosis from physicians when not recorded in medical records.
• Determines the sequence of diagnoses for accurate claims submission.
• Employs knowledge of coding compliance and directs efforts to achieve quality standards identified through coding reviews or targeted by management for improvement.
• Guides and provides mentoring related to coding projects done by Coding Specialist I and Coding Specialist II to include review and correction of code selection based upon medical documentation.
• Handles complex coding case review including but not limited to surgical coding (Orthopaedics Cardiac Neurosurgery Otolaryngology etc.), extraction, co-surgery scenarios, multi-visceral transplant cases, comorbidity evaluation.
• Identifies and reports issues and trends in physician documentation and/or work routed to Coding from other departments.
• Identifies coding trends relative to edits/denials/physician feedback.
• Maintains continuing education and credentials as required for job classification.
• Provides guidance to Coding Specialists I and II related to complex edit and appeal scenarios.
• Recommends policy and procedural changes and improvements for revenue enhancement.
• Surveys Medical Professional Societies coding guidelines to ensure the usage of current coding combinations and rationale.

Qualifications

• Education: High School Diploma or GED required. Bachelor's degree preferred.
• Experience: 5-7 years medical-professional coding experience with demonstrated ability to work independently required. 2 years' experience leading others or leading a work stream required. Experience with computer systems for encoding and abstracting required. Additional years of experience strongly preferred.
• Licenses and Certifications: CPC (Certified Professional Coder) certification required.