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Professional Coder II, PB Coding

This job posting is no longer active.

Winston Salem, NC, United States
Job ID: 96543
Job Family: Medical Records Services
Status: Full Time
Shift: Day
Remote Opportunity: Yes
Job Type: Regular
Department Name: 55811088941322-Profee Coding

Overview

Professional Coder II, Provider Based Coding

40 hours per week, day shift

JOB SUMMARY:  Under general supervision, abstracts and codes hospital based, inpatient hospital, outpatient and ambulatory physician (and mid-level provider) services and special procedures (e.g., Emergency Room, Ambulatory Surgery, Day Hospital, Sticht Center, Forsyth Hospital).  Uses standard ICD diagnosis and CPT professional coding guidelines, Medicare, Medicaid and other third party regulations/requirements, as well as internal coding guidelines, in order to provide data for billing and reimbursement.

EDUCATION/EXPERIENCE:  High school diploma or GED equivalent with two years of medical coding experience in a similar environment, or eligibility for internal promotion based on achieving and maintaining Coder level II performance criteria by department for six consecutive months.

LICENSURE, CERTIFICATION, and/or REGISTRATION:  National coding certification (CPC or CCS).

ESSENTIAL FUNCTIONS:

1.    Responsible for timely and accurate coding of hospital based professional services (outpatient hospital or inpatient hospital; single services or complete inpatient stays) by reading and/or reviewing medical record documentation  to assign and  sequence diagnoses and procedure codes  according to coding guidelines, and enter into the electronic system: 
      a.    Appropriate diagnoses codes, professional service codes and modifiers and/or facility service/ charge codes.
      b.    Assign and record appropriate modifiers (i.e., GC, NO or NDU) as appropriate based on Teaching Physician rules. 
2.    Maintains a current knowledge of ICD diagnosis codes, CPT physician service codes, internal codes (for unlisted or unusual CPT codes), and governmental (Medicare, Medicaid, TriCare), commercial and managed care regulations by reading relevant professional literature and by attending workshops and lectures.
3.    Accrues sufficient continuing education hours to maintain national coding certification. 
4.    Serves as a resource for less experienced medical coders. 
5.    Works collaboratively with team members, Corporate Revenue Cycle, and Compliance Analysts to answer questions and/or resolve issues related to documentation, coding and billing of professional services and/or facility services.
6.    Provides physician education to ensure documentation is sufficient for greatest accuracy of coding.
7.    Resolves pending charges in the WakeOne coding work queues including claim denial work queues.
8.    Performs other related duties incidental to the work described herein.

SKILLS/QUALIFICATIONS:

  • Experience in coding of physician professional services in a teaching environment
  • Familiarity with Medicare Teaching Physician Rules
  • Familiarity with facility fee services within a Provider Based clinic
  • Ability to meet and maintain performance standards of quality and productivity for Level II Coder by department

WORK ENVIRONMENT:

  • Clean, well-lit, comfortable environment
  • Quiet work area

PHYSICAL REQUIREMENTS:
0%    35%    65%        
to    to    to        
35%    65%    100%    N/A    Activity
X                Standing
X                Walking
        X        Sitting
X                Bending
        X        Reaching with arms
        X        Finger and hand dexterity
        X        Talking
        X        Hearing
        X        Seeing
                Lifting, carrying, pushing and or pulling:
X                20 lbs. maximum
X                50 lbs. maximum
X                100 lbs. maximum