Professional Physician Coder III

Davita Inc.; Greensboro (NC); On-site; USD 50,000 - 80,000; Full time

Job summary

An established industry player is seeking a Professional Physician Coder III to join their dynamic team. This role is essential for ensuring accurate coding and billing of physician services while educating staff and identifying revenue opportunities. With a focus on multi-specialty coding and compliance, you'll play a vital role in maximizing reimbursement and maintaining patient confidentiality. Join a diverse and inclusive environment that values your skills and contributions, making a meaningful impact on patient care and community service.

Qualifications

• 5+ years of certified coding experience in professional coding.
• Proficiency in multi-specialty E/M coding and minor bedside procedures.

Responsibilities

• Review medical records and code physician services using ICD-10, CPT, and HCPCS.
• Assist in maximizing reimbursement and handle insurance denials.

Skills

ICD-10 Coding

CPT Coding

HCPCS Coding

Multi-specialty E/M Coding

Surgical Coding

Communication Skills

Education

High School Diploma

Associate Degree in Medical Office Billing

Job description

Job Title: Professional Physician Coder III

The Professional Physician Coder III accurately and efficiently accesses a wide range of complex, specialty physician billing and Health Information Systems to gather all necessary records for accurate coding and billing of professional physician and/or physician extender (mid-level) services. This role also involves educating physicians, management, support staff, and administration, as well as identifying potential revenue opportunities.

Responsibilities:

1. Review medical records and code physician services using current ICD-10, CPT, and HCPCS classification systems.
2. Code diagnoses, co-morbidities, complications, therapeutic and diagnostic procedures, supplies, materials, injections, and drugs.
3. Assist the Central Business Office in ensuring proper follow-up of patient accounts to maximize reimbursement, including handling insurance denials.
4. Report any compliance violations to the Team Lead, Manager, or Compliance department.
5. Communicate effectively with physicians, physician extenders, offices, coding team members, and management.
6. Utilize departmental resources to support accurate coding practices.
7. Maintain patient confidentiality.
8. Perform other duties as assigned.

Qualifications:

Education:

• Required: High school diploma or equivalent.
• Preferred: Associate degree, preferably in Medical Office Billing.

Experience:

• Required: Minimum of five years certified coding experience in professional or physician practice coding, with proficiency in multi-specialty E/M coding and minor bedside procedures. Knowledge of surgical coding and abstracting. Experience with complex specialties such as Anesthesia, Vascular, Surgery, and Pain Management is preferred.

Licensure/Certification:

• Required: One of the following national certifications:
  1. Certified Professional Coder (CPC) - American Academy of Professional Coders
  2. Certified Coding Specialist (CCS) - AHIMA
  3. Certified Coding Specialist-Physician (CCS-P) - AHIMA
  4. Certified Medical Coder (CMC) - Practice Management Institute

At Cone Health, we are committed to creating a diverse and inclusive environment. We offer equal employment opportunities to all applicants and employees, regardless of race, religion, age, sex, sexual orientation, gender identity, veteran's status, ethnicity, national origin, disability, or any characteristic protected by law. Our hiring decisions are based on qualifications, skills, and performance, and we believe embracing diversity enhances our service to patients and communities.