Physician Coder, Sr

Position Summary

Accurately and efficiently accesses wide range 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

Responsibilities

• 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)

• Verifies billable physician services by reviewing physician documentation for adherence to the "Physician at Teaching Hospital" rules set forth by the federal government.

• Submits to their direct management any issues or trends found within the documentation of a particular healthcare provider for evaluation and follow up.

• Collaborates with members of the specialty team to consistently monitor financial goals within their specialty to satisfy corporate goals.

• Assists with the Central Business Office to ensure appropriate and complete follow up of patient accounts to maximize reimbursement (i.e., Insurance Denials)

• 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.

• Demonstrates good communication skills both verbal and written.

• Maintains 90% accuracy rate.

• Attends departmental and other meetings as scheduled.

• Provides data for production reports.

• Serves as mentor to Physician Coders I and Physician Coders II

• Serves as Management support.

• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state, and local standards.

• Maintains compliance with all Orlando Health policies and procedures.

Qualifications

Education/Training

• High school diploma or equivalent.

• Computer/typing literacy, knowledge of Anatomy, Physiology and Medical terminology required.

• Thorough knowledge of CPT, ICD coding as evidenced by results of coding skills test of 80% or better.

Licensure/Certification

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 Coding Associate (CCA) through the American Health Information Management Association (AHIMA)

• Certified Medical Coder (CMC) through Practice Management Institute

Experience

• Five (5) years certified coding experience in professional or physician practice coding.

• Proficiency in multi-specialty E/M coding is required

• Proficiency in multi-specialty minor bedside procedures is required

• Proficiency in (1) specialty surgical coding is required, and multi-specialty surgical coding is desired

Education/Training

• High school diploma or equivalent.

• Computer/typing literacy, knowledge of Anatomy, Physiology and Medical terminology required.

• Thorough knowledge of CPT, ICD coding as evidenced by results of coding skills test of 80% or better.

Licensure/Certification

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 Coding Associate (CCA) through the American Health Information Management Association (AHIMA)

• Certified Medical Coder (CMC) through Practice Management Institute

Experience

• Five (5) years certified coding experience in professional or physician practice coding.

• Proficiency in multi-specialty E/M coding is required

• Proficiency in multi-specialty minor bedside procedures is required

• Proficiency in (1) specialty surgical coding is required, and multi-specialty surgical coding is desired

• 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)

• Verifies billable physician services by reviewing physician documentation for adherence to the "Physician at Teaching Hospital" rules set forth by the federal government.

• Submits to their direct management any issues or trends found within the documentation of a particular healthcare provider for evaluation and follow up.

• Collaborates with members of the specialty team to consistently monitor financial goals within their specialty to satisfy corporate goals.

• Assists with the Central Business Office to ensure appropriate and complete follow up of patient accounts to maximize reimbursement (i.e., Insurance Denials)

• 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.

• Demonstrates good communication skills both verbal and written.

• Maintains 90% accuracy rate.

• Attends departmental and other meetings as scheduled.

• Provides data for production reports.

• Serves as mentor to Physician Coders I and Physician Coders II

• Serves as Management support.

• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state, and local standards.

• Maintains compliance with all Orlando Health policies and procedures.