Physician Practice Coder - Remote

About the role

The Physician Practice Coder position is responsible for accurate and compliant coding of surgical cases for multiple specialties across all care settings. This position directly impacts revenue integrity by ensuring optimal CPT / ICD-10-CM / HCPCS II coding and appropriate modifiers, along with minimizing payer front end rejections and denials. The Physician Practice Coder is a resource for the physicians and other health care providers in regard to coding and to review medical documentation to insure appropriate physician coding and billing. Works closely with key revenue cycle stakeholders to understand reasons for denials, root cause analysis, and feedback to providers.

Responsibilities

• Perform coding and related duties of moderate and high complexity surgical cases, and Evaluation and Management services, using established guidelines in an accurate and timely manner.
• Review medical documentation and system generated charges or paper encounter forms.
• Appropriately assign CPT, ICD-10, HCPCS II, and modifiers based on documentation and payor requirements.
• Research billing rules and regulations for new and existing procedures.
• Demonstrate a commitment to integrating coding compliance standards into daily coding practices.
• Identify, correct and report potential coding problems.
• Maintains knowledge of coding and professional skills, including maintaining yearly coding credentials through attendance at in-service programs, workshops, review of current literature and other educational programs.
• Resolves coding edits and denials in a timely manner.
• Identify opportunities to reduce denials and enhance revenue.
• Provide cross coverage of multiple specialties.
• Function as a resource to external customers.
• Research and resolve coding questions/inquiries.
• Make recommendations for coding policy changes.
• Functions as subject matter expert for