Specialist Physician Services Coder II

Tenet Healthcare; United States; On-site; USD 29,000 - 43,000; Full time

Benefits offered by this job

Signing bonus

Medical, dental, vision insurance

401k with employer match

Paid time off

Health savings accounts

Job summary

Conifer is seeking a SPEC, PHYS SVC CODING II to code physician charges using ICD-10, CPT, HCPCS and modifiers from medical records. The role requires using multiple resources to determine codes and resolving pre-bill edits and coding denials, with productivity and accuracy targets set by internal audits.

Candidates typically have 3–5 years coding experience, CPC or CCS-P certification, and strong knowledge of coding rules, reimbursements, and documentation.

Qualifications

• Vocational or technical education beyond high school.
• Minimum of 3-5 years coding experience.
• CPC or CCS-P or equivalent certification Multi‑specialty Evaluation and Management coding.
• Demonstrate working knowledge of medical terminology, human anatomy, and coding rules and regulations.
• Must possess knowledge of third‑party reimbursement regulations and billing practices.
• Ability to examine documents for accuracy and completeness.
• Detail oriented with the ability to identify and resolve problems.
• Must possess knowledge of CCI, LCD, NCD and other applicable coding rules and regulations.
• Ability to communicate clearly and work effectively with co‑workers.
• Proficient in Microsoft Word, Excel.

Responsibilities

• Assign ICD-10, CPT, HCPCS and modifiers codes from documentation
• Review and appropriately resolve pre-bill edits
• Review and appropriately resolve coding denials
• Meet or exceed productivity standards
• Meet or exceed accuracy rate of 95.5% in monthly internal audits
• Effectively present coding issues to internal team members, internal clients, or external clients
• Deliver information in a one‑on‑one or small group format to peers
• Meet deadlines and complete assignments before monthly closing dates
• Locate and apply CCI, LCD, NCD and other applicable coding rules and client specific guidelines
• Other duties as assigned

Job description

JOB SUMMARYThe primary purpose of the SPEC, PHYS SVC CODING II is to code physician charges by assigning ICD-10, CPT, HCPCS codes and modifiers from medical record documentation. Must have the ability to utilize multiple resources to support code assignment. Must possess knowledge on how to resolve coding denials and pre-bill coding edits. Productivity and accuracy are measured via internal audits and must be maintained. Level II roles include but are not limited to evaluation and management coding, radiology, and emergency department coding.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Assign ICD-10, CPT, HCPCS and modifiers codes from documentation
• Review and appropriately resolve pre-bill edits
• Review and appropriately resolve coding denials
• Meet or exceed productivity standards
• Meet or exceed accuracy rate of 95.5% in monthly internal audits
• Effectively present coding issues to internal team members, internal clients, or external clients
• Deliver information in a one‑on‑one or small group format to peers
• Meet deadlines and complete assignments before monthly closing dates
• Locate and apply CCI, LCD, NCD and other applicable coding rules and client specific guidelines
• Other duties as assigned

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

EDUCATION / EXPERIENCE

• Vocational or technical education beyond high school
• Minimum of 3-5 years coding experience
• CPC or CCS-P or equivalent certification Multi‑specialty Evaluation and Management coding
• Demonstrate working knowledge of medical terminology, human anatomy, and coding rules and regulations
• Must possess knowledge of third‑party reimbursement regulations and billing practices
• Ability to examine documents for accuracy and completeness
• Detail oriented with the ability to identify and resolve problems
• Must possess knowledge of CCI, LCD, NCD and other applicable coding rules and regulations
• Detail oriented with the ability to identify and resolve problems
• Ability to communicate clearly and work effectively with co‑workers
• Ability to work as a team member in all activities
• Conduct self in an ethical, honest, and professional manner
• Demonstrate continued willingness to learn and grow
• Proficient in Microsoft Word, Excel

POSITION COMPETENCIES:

Builds Team Relationships - Invites others to share opinions. Partners with employees in other departments. Actively seeks ways to help team members.Communicates Effectively – Expresses ideas clearly and succinctly with small or large audiences. Listens attentively to speaker’s message without interruption. Tailors writing to audience using correct grammar and spelling.Compliance with Laws, Policies and Procedures - Adheres to company handbook and policies. Demonstrates behavior consistent with Code of Conduct. Adheres to compliance program and guidelines.Develops Self - Seeks opportunities for continuous learning. Modifies behavior in response to feedback. Knows personal strengths and weaknesses and demonstrates ownership for personal development.Displays Adaptability – Performs well in high pressure or stressful situations. Works effectively when direction is unclear or rapidly changing. Demonstrates persistence in the face of obstacles.Drives for Results - Delivers high quality work and attains results. Demonstrates personal drive and pushes self and others for results and quality work. Response appropriately to urgent situations.Focus on the Customer/Client – Ensures that clients have a positive experience. Responds to clients in a timely manner. Demonstrates tact and empathy when responding to clients.Respects Others - Displays sensitivity to the needs and concerns of others. Interacts with others in an open, non‑threatening manner.Shows Reliability – Takes personal responsibility for actions and decisions. Consistently works assigned schedule. Acts responsibly and can be counted on to accomplish goals successfully.

Compensation and Benefit InformationCompensation

• Pay: $20.51 - $30.77 per hour. Compensation depends on location, qualifications, and experience.
• Position may be eligible for a signing bonus for qualified new hires, subject to employment status.
• Conifer observed holidays receive time and a half.

Benefits

Conifer offers the following benefits, subject to employment status:

• Medical, dental, vision, disability, and life insurance
• Paid time off (vacation & sick leave) – min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked.
• 401k with up to 6% employer match
• 10 paid holidays per year
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
• For Colorado employees, Conifer offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.