Physician Coder IV, Professional Billing
- 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.
- Focused background on 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.
- High School diploma, general equivalency diploma (GED), and/or GED equivalent programs.
- Minimum of 4+ years of coding experience, Trauma Level 1 and Academic Teaching facility.
- Strong understanding of physiology, medical terms and anatomy.
- Proficient in Profee Coding and E/M guidelines (95/97, 2021 update).
- Proficient in coding CPT for all Inpatient and Outpatient Operating Room procedures.
- 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.
- Multiple years of coding experience, Trauma Level 1 and Academic Teaching facility.
- Background in multi-specialty Physician services.
- 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.
- An approved American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) coding credential.
- Labor Market Data: Compensation is benchmarked against market data to ensure competitiveness.
- Experience: Years of relevant work experience.
- Education and Certifications: Level of education attained, including specialized certifications, credentials, completed apprenticeship programs or advanced training.
- Skills: Demonstrated proficiency in relevant skills and competencies.
- Geographic Location: Cost of living and market rates for the specific location.
- Internal Equity: Compensation is determined in a manner consistent with compensation ranges for similar roles within the organization.
- Budget and Grant Funding: Departmental budgets and any grant funding associated with the job position may impact the pay that can be offered.
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