Day (United States of America)

Physician Coding Specialist I

The Physician Coding Specialist is responsible for coding and auditing physician documentation and will work directly with Physicians and Mid-level providers to provide feedback on documentation and coding accuracy. The Physician Coding Specialist is responsible for reviewing patient medical records and extracting all applicable ICD10 and CPT codes for billing purposes.

- Minimum two (2) year college coding course including anatomy, physiology, medical terminology, CPT-4, HCPCS and ICD-10-CM CCSP, CPC or equivalent certifications preferred
- Professional coding and/or auditing experience in a hospital setting preferred.
- Knowledge of Local Coverage Determinations and National Coverage Determinations (LCD/NCD) medical necessity requirements
- Knowledge of regulatory and third party payer requirements
- Professionalism in interpersonal communication skills with physicians, colleagues, and ancillary departments required
- The ability to organize, prioritize, analyze, and implement daily tasks; must be a self-starter
- The ability to handle multiple responsibilities and tasks in stressful situations
- The ability to maintain confidentiality; knowledge of HIPAA laws
- Performs chart reviews for professional fee claims for appropriate code assignment.
- Interacts with providers alongside Coder III or Coding Coordinator to review audit findings.
- Comply with changes in regulatory requirements such as changes to government billing policies and instructions.
- Provide education regarding level of service and diagnosis coding consistent with established coding guidelines and standards to providers
- Perform work in accordance to internal standards
- All other duties as assigned and consistent with the Job Summary

- EPIC experience preferred

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