Professional Coder ll - Radiology

Essential Functions

• Code hospital-based professional services accurately and on time, including outpatient or inpatient hospital services, single services, and complete inpatient stays.
• Review medical record documentation to assign and sequence diagnosis and procedure codes in accordance with coding guidelines.
• Enter appropriate diagnosis codes, professional service codes, modifiers, and facility service or charge codes into the electronic system.
• Assign and record appropriate modifiers, including GC, NO, or NDU, in accordance with Teaching Physician Rules.
• Maintain current knowledge of ICD diagnosis codes, CPT physician service codes, internal codes for unlisted or unusual procedures, and Medicare, Medicaid, TRICARE, commercial, and managed care regulations.
• Stay informed through professional literature, workshops, and lectures.
• Complete sufficient continuing education hours to maintain national coding certification.
• Serve as a resource for less experienced medical coders.
• Collaborate with team members, Corporate Revenue Cycle, and Compliance Analysts to answer questions and resolve documentation, coding, and billing issues involving professional or facility services.
• Educate physicians to support documentation that enables the greatest possible coding accuracy.
• Resolve pending charges and claim denials in WakeOne coding work queues.
• Perform other related duties incidental to the work described.

Skills and Qualifications

• Experience coding physician professional services in a teaching environment.
• Familiarity with Medicare Teaching Physician Rules.
• Familiarity with facility fee services within a provider-based clinic.
• Ability to meet and maintain department-defined Level II Coder quality and productivity standards.

Education and Experience

• High school diploma or GED equivalent.
• Two years of medical coding experience in a similar environment; or
• Eligibility for internal promotion after achieving and maintaining department-defined Coder Level II performance criteria for six consecutive months.

Licensure, Certification, and Registration

• Active national coding certification: Certified Professional Coder (CPC) or Certified Coding Specialist (CCS).

Work Environment

• Clean, well-lit, and comfortable environment.
• Quiet work area.

Physical Requirements

• Activities may include standing, walking, sitting, bending, reaching with the arms, using finger and hand dexterity, talking, hearing, and seeing.
• May involve lifting, carrying, pushing, or pulling items with listed maximum weights of 20 pounds, 50 pounds, or 100 pounds, as applicable to the role.
• The source frequency table does not clearly identify the percentage assigned to each activity; confirm the applicable frequency and lifting category with the department.