Professional Physician Coder III

Cone Health; Jamestown (NC); On-site; USD 75,000 - 95,000; Full time

Job summary

Cone Health seeks a Professional Physician Coder III to accurately code complex physician services and support billing efforts. You will review records, educate staff, and identify revenue opportunities while maintaining strict confidentiality.

The role requires five years of certified coding experience in professional or physician practice coding and proficiency across ICD-10, CPT, and HCPCS. Collaboration with clinicians and the central billing office is essential.

Qualifications

• 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.

Responsibilities

• Reviews medical records and codes physician services utilizing ICD-10, CPT and HCPCS classifications.
• Codes diagnosis, co-morbidities, complications, therapeutic and diagnostic procedures, supplies, injections, and drugs with ICD-10, CPT, HCPCS.
• Assists Central Business Office to maximize reimbursement (Insurance Denials).
• Notifies Team Lead, Manager, and/or Compliance of any compliance violations discovered during review.
• Communicates effectively with physicians, physician extenders, offices, coding team and manager.
• Utilizes department material to support accurate coding practices.
• Maintains patient confidentiality.
• Performs other duties as assigned.

Skills

Medical coding

Attention to detail

Communication

Education

High School Diploma or equivalent

Associate's Degree in Medical Office Billing (preferred)

Job description

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.