Professional Physician Coder III

About the role

The Professional Physician Coder III accurately and efficiently accesses a wide range of complex, specialty physician billing and Health Information Systems to secure and gather all necessary records to accurately code and bill professional physician and/or physician extender (mid-level) services. This role assists with educating physicians, management, support staff and administration and also identifies possible revenue opportunities.

Responsibilities

• Reviews medical records and codes physician services utilizing current ICD-10, CPT and HCPCS classification systems.
• Codes diagnosis, co-morbidities, complications, therapeutic and diagnostic procedures, supplies, materials, injections, and drugs with International Classification of Diseases (ICD-10), Current Procedural Terminology (CPT), and Heath Care Financing Administration Common Procedure Coding Systems (HCPCS – all levels).
• Assists with the Central Business Office to ensure appropriate and complete follow up of patient accounts to maximize reimbursement (i.e., Insurance Denials).
• Notifies Team Lead, Manager, and/or Compliance department of any compliance violations that are discovered during the review process.
• Communicates effectively with physicians, physician extenders, physician offices, members of the coding team and manager.
• Utilizes resource material available in department to support accurate coding practices.
• Maintains patient confidentiality.
• Performs other duties as assigned.

Qualifications

• Education: High School Diploma or equivalent required. Associate's Degree preferably with Medical Office Billing preferred.
• Experience: Five years certified coding experience in professional or physician practice coding required. Proficiency in multi-specialty E/M coding along with minor bedside procedure coding required. Knowledge of surgical coding and abstracting required. Previous experience working with complex medical and surgical specialties such as Anesthesia, Vascular, Surgery and Pain management preferred.
• Licensure/Certification: One of the following national certifications required: Certified Professional Coder (CPC) through the American Academy of Professional Coders; Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA); Certified Coding Specialist-Physician (CCS-P) through AHIMA; or Certified Medical Coder (CMC) through Practice Management Institute.