Professional Physician Coder III

The Professional Physician Coder III accurately and efficiently accesses wide range 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. This role also identifies possible revenue opportunities.

Essential Job Function:

• Reviews medical records and codes physician services utilizing current ICD-10, CPT and HCPCS classifications 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), 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 (ie, 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.

Education:

• Required: High School Diploma or equivalent.
• Preferred: Associate's Degree preferably with Medical Office Billing.

Experience:

• Required: Five years certified coding experience in professional or physician practice coding.
• Proficiency in multi-specialty E/M coding along with minor bedside procedure coding.
• Knowledge of surgical coding and abstracting.
• Preferred: Previous experience working with complex medical and surgical specialties such as Anesthesia, Vascular, Surgery and Pain management as an example.

Licensure/Certification/Listing:

• Required: One of the following national certifications: 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 the American Health Information Management Association (AHIMA). Certified Medical Coder (CMC) through Practice Management Institute.