Physician Practice Coder

Role Overview

• Conducts CPT and ICD-10 coding reviews by detailed examination of each line item in the physician medical record
• Performs chart audits to ensure correct coding and charge capture
• Works closely with key revenue cycle stakeholders to understand reasons for denials, root cause analysis, and feedback to providers
• Reviews patient medical records and abstracts medical data that identifies all diagnoses and procedures
• Codes diagnoses, procedures, and appropriate modifiers from the medical record documentation using ICD-10-CM, CPT4/HCPCS classification systems
• Refers to a computerized encoding system, written coding aids and other reference materials to ensure accurate coding for billing
• Sequences diagnoses, procedures and complications by following ICD-10-CM, CPT-4, and the Uniform Hospital Discharge Data Set (UHDDS)
• Consults with the CDCI team to request appropriate physician or appropriate medical staff to clarify medical record information.
• Maintains productivity standards set forth in Departmental Policies and procedures
• Maintains knowledge of coding and professional skills
• Utilizes hospital’s cultural values as the basis for decision making and to facilitate the hospital’s goals and mission
• Follows established Hospital infection control and safety procedures.
• Review and respond to coding questions
• Ensure billed service is being accurately coded
• Perform random chart audits
• Provide continual coding updates
• Research coding issues that arise
• Codes diagnoses and procedures from the medical record using ICD-10-CM and CPT-4/HCPCS classification systems
• Sequences diagnoses, procedures and complications by following ICD-10-CM, Medicare, Medicaid, and other fiscal intermediary guidelines
• Reviews charts for documentation and signature
• Performs other duties as needed
• Must adhere to all of BMC’s RESPECT behavioral standards

Requirements

• Associates Degree (or direct work experience equivalent to at least 2 years)
• CPC – Certified Professional Coder
• CPC-A – Certified Professional Coder Apprentice
• 2-5 years experience required in a multi-specialty physician coding environment to include coding, compliance, and billing processes.
• in-depth knowledge of medical terminology, ICD-10-CM and CPT-4
• basic concepts of human anatomy, physiology and pathology
• knowledge of health records, computerized billing and charging systems, Microsoft applications, data integrity, and processing techniques required

Benefits

• medical, dental, vision, pharmacy
• discretionary annual bonuses
• merit increases
• Flexible Spending Accounts
• 403(b) savings matches
• paid time off
• career advancement opportunities
• resources to support employee and family well-being