Coder III, Physician Billing

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The Physician Coder III is responsible for accurately abstracting data following the Official International Classification of Diseases (ICD)-10-Clinical Modification (CM), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) Guidelines for Coding and Centers for Medicare and Medicaid Services (CMS) directives across Hackensack Meridian Health (HMH) network. Performs data entry of required abstracted patient information into the electronic medical record system. Queries physicians when appropriate.

A day in the life of a Physician Coder III at Hackensack Meridian Health includes:

• Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines and coding conventions.
• Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications.
• Analyzes medical records and identifies documentation deficiencies.
• Reviews and verifies documentation supports existing diagnoses, procedures and other charges.
• Identifies reportable elements, complications, and other quality measures.
• Communicates with physicians to clarify information via the physician query process
• Assign CPT, HCPCS and ICD-10-CM codes.
• Proficient in Profee Coding and E/M guidelines (95/97, 2021 update)
• Knowledge of and ability to address National Correct Coding Initiative (NCCI) and National Coverage Determinations (NCD) / Local coverage determinations (LCD) edits.
• Maintains required productivity and quality requirements.
• Other duties and/or projects as assigned.
• Adheres to HMH Organizational competencies and standards of behavior.

Education, Knowledge, Skills and Abilities Required:

• High School diploma, general equivalency diploma (GED), and/or GED equivalent programs.
• Minimum of 3+ years of coding experience, Trauma Level 1 and Academic Teaching facility.
• Focused background in Physician and Profee coding with knowledge of E/M guidelines.
• Proficient in coding in office/outpatient procedures in an office and outpatient hospital setting.
• Strong understanding of physiology, medical terms and anatomy.
• Proficiency in computer skills including typing speed and accuracy.
• Excellent written and verbal communication skills.
• Proficient computer skills including but not limited to Microsoft Office and Google Suite platforms.

Education, Knowledge, Skills and Abilities Preferred:

• Multiple years of coding experience, Trauma Level 1 and Academic Teaching facility.
• Background in multi-specialty Physician services.

Licenses and Certifications Required:

• Registered Health Information Technician or Registered Health Information Administrator Certification or Certified Coding Specialist or Certified Professional Coder.
• An approved American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) coding credential.

Licenses and Certifications Preferred:

• An approved American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) coding credential.