Physician Coding Senior Coder Surgical Pediatric

Banner Health; Baton Rouge (LA); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading healthcare organization is seeking a Physician Coding Senior Coder for surgical pediatric cases. This remote position requires expertise in complex coding, with responsibilities including analyzing medical records, ensuring compliance, and mentoring new coders. Ideal candidates will have significant coding experience and relevant certifications.

Qualifications

• Requires CPC, CCS, CCS-P, RHIA, or RHIT certification.
• Five or more years of complex professional coding experience.
• Demonstrates high knowledge of ICD and CPT coding principles.

Responsibilities

• Analyzes medical information and accurately codes diagnostic and procedural information.
• Provides quality assurance for medical records and ensures compliance with coding rules.
• Mentors less experienced staff and assists in onboarding new coders.

Skills

Attention to detail

Critical thinking

Organization

Education

High school diploma/GED or equivalent

Associate’s degree in a related healthcare field

Job description

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Join to apply for the Physician Coding Senior Coder Surgical Pediatric role at Banner Health

Estimated Pay Range: $26.82 - $40.22 / hour, based on location, education, & experience.

Department Name: Coding Ambulatory

Work Shift: Day

Job Category: Revenue Cycle

Position Summary: This position performs full range of complex professional coding in support of specialty or multi-specialty physician practices by evaluating medical records and validating that appropriate clinical diagnosis and procedure codes are assigned in accordance with nationally recognized coding guidelines. Utilizes coding knowledge and expertise to support department projects, validation edits, and revisions. Participates and leads in training and onboarding of new staff. Participates and leads coding round table discussions.

Core Functions:

• Analyzes medical information from medical records. Accurately codes diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely, and accurate coding in accordance with department-specific productivity and quality standards. Codes ICD CM and CPT4 for accurate APC assignment. Addresses National Correct Coding Initiative (NCCI) edits as appropriate. Reconciliation of charges as required.
• Abstracts clinical diagnoses, procedure codes, and documents other pertinent information obtained from the medical record into the electronic medical records. Seeks out missing information and creates complete records, including items such as disease and procedure codes, discharge disposition, date of surgery, attending physician, consulting physicians, surgeons, and anesthesiologists, and appropriate signatures/authorizations. Refers inconsistent patient treatment information/documentation to coding quality analysts, supervisor, or individual department for clarification/additional information for accurate code assignment.
• Provides quality assurance for medical records. Ensures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, CMS, OIG, HCFA, and professional standards.
• Compiles daily and monthly reports; tabulates data from medical records for research or analysis purposes.
• Able to identify validation edits and revision issues to ensure compliant coding.
• Recognizes and distinguishes complex diagnoses and procedures with attention to detail to make corrections and ensure accurate coding, reimbursement, and compliance.
• Provides mentoring for less experienced staff and acts as subject matter expert for complex coding. Assists in onboarding new coders, including daily functions, system training, policies, and procedures.
• Works independently, managing and prioritizing work assignments. Uses specialized knowledge to ensure accurate ICD/CPT code assignment according to national guidelines. Addresses complex coding matters independently prior to escalation.

Minimum Qualifications: High school diploma/GED or equivalent, plus specialized formal training or an Associate’s degree in a related healthcare field. Requires at least one of the following certifications: CPC, CCS, CCS-P, RHIA, or RHIT, active with AHIMA or AAPC. Must have five or more years of complex professional coding experience in clinical specialty areas. Demonstrates high knowledge of ICD and CPT coding principles. Ability to work autonomously, with excellent critical thinking, organization, and attention to detail. Capable of working effectively remotely using office programs and coding systems.

Preferred Qualifications: Radiology Certified Coder (RCC) or other specialty coding certifications.

Additional: Position is remote and available only in specified states. Flexible hours between 7 am – 7 pm, Monday-Friday, with a focus on productivity.