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Specialty Physician Coder

Integrated Resources, Inc

Fountain Valley, CA

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JOB DETAILS
JOB TYPE
Contractor
SKILLS
Analysis Skills, Anatomy, Benchmarking, Billing, Cardiac Surgery, Cardiology, Catheterization, Code Reviews, Communication Skills, Critical Care, Current Procedural Terminology (CPT), Customer Support/Service, Detail Oriented, Documentation, Epic Systems, Establish Priorities, Gastroenterology, Healthcare, Healthcare Common Procedure Coding System (HCPCS), Hematology, Hospital, ICD-10, Insurance, Interpersonal Skills, Maintain Compliance, Medical Coding, Medical Office, Medical Records, Medical Terminology, Medical Tests, Medical Treatment, Meeting Minutes, Microsoft Office, Multitasking, Obstetrics and Gynecology, Oncology, Organizational Skills, Outpatient Care, Patient Care, Patient Confidentiality, Physiology, Policy Development, Presentation/Verbal Skills, Problem Solving Skills, Process Improvement, Quality Metrics, Radiation Therapy, Regulatory Compliance, Reimbursement, Relationship Management, Respiratory Medicine, Risk, Safety/Work Safety, Surgical Procedures, Team Player, Time Management, Trend Analysis, Work From Home
LOCATION
Fountain Valley, CA
POSTED
30+ days ago
Role Requirements: Cardiology and cardiac surgery experience Strong critical care knowledge Must be able to abstract chart reviews to capture all billable charges CCC certification required Must be knowledgeable in heart catheterizations EPIC experience required (charge entry and charge review) Strong Evaluation and Management (E/M) inpatient and outpatient coding experience Must reside in CA but can work remotely Profee ONLY NOT HCC/risk adjustment, ASC, or facility coding Desire to convert to full-time employment Bonus Experience working on denials GI (CGIC coding certification) or OBGYN (COBGC coding certification) coding experience (1 year or more) Under the direction of the Coding Compliance Manager, the Specialty Physician Coder plays a key role in reviewing and analyzing specialty coding and billing for charge processing. This role is responsible for reviewing and accurately coding office, hospital, and surgical/procedures for reimbursement, ensuring accurate and compliant medical coding for inpatient and outpatient services, diagnostic tests, and other medical services rendered to patients. The Specialty Physician Coder will also collaborate with the Coding Compliance Manager to identify coding trends, irregularities, and required action items. Essential Functions and Responsibilities: Proficient in Microsoft Office Suite Proficient in Epic software Strong analytical skills Strong critical thinking skills Detail-oriented Ability to anticipate, research, and resolve problems with strong problem-solving skills Strong understanding of the healthcare revenue cycle Excellent communication skills with the ability to convey information accurately and clearly Ability to manage interpersonal relationships and communicate effectively with clinical partners and business center teams Provide excellent customer service and manage a moderate volume of incoming emails and phone calls Collaborative team player with the ability to adapt to a dynamic healthcare environment Maintain a professional demeanor at all times Ability to handle complex and confidential information with discretion Maintain patient confidentiality Maintain a safe and organized work area Strong work ethic; honest and dependable Strong personal time management skills Maintain regular attendance and punctuality Follow company policies, procedures, and directives Interact in a positive and constructive manner Ability to prioritize and multitask Skills: Meet productivity standards established by management Meet quality standards established by management. In adherence with standard work, analyze and interpret medical records and assign and sequence appropriate ICD-10-CM, CPT, and/or HCPCS codes for office, inpatient, and/or outpatient records according to established coding guidelines, including the ability to review and code surgical operative and/or procedure reports Follow established workflows for claim denials in Follow-Up work queues, identify opportunities for billing/coding improvements, and participate in coding compliance monitoring, benchmarking, policy development, and physician documentation improvement programs. Analyze denial trends and optimize processes within Follow-Up and Claim Edit work queues Provide ongoing communication and education to MCMF providers to maximize coding compliance and reimbursement. Adhere to Coding Compliance department communication standards and collaborate with Physician Billing Services Insurance and Customer Service teams to resolve billing and coding issues. Perform monthly coding change report analysis and communicate trends to providers as needed Work weekly Missing Charge Reports to identify missed billable charges and maximize reimbursement Organize, attend, and participate in specialty provider meetings. Prepare presentation materials, document meeting minutes, follow up on action items, and report to the Coding Compliance Manager Take responsibility for assigned projects and perform additional duties as requested by management Other duties as assigned Experience: 3 years of experience working in a hospital or physicians office as a medical coder, including interaction with physicians 1 year of experience as a specialty coder in one of the following: Cardiology, Gastroenterology, Medical Hematology/Oncology, OBGYN, Pulmonology, General Surgery, or Radiation Oncology Expert knowledge of ICD-10, CPT, and HCPCS Strong knowledge of medical terminology, anatomy, and physiology Epic software experience highly preferred Proficient in Microsoft Office

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Integrated Resources, Inc

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