[Hiring] MEDICAL CODER SPECIALIST @Duke Health

Role Description

The Medical Coder Specialist will have frequent and daily interactions with internal and external clients, including but not limited to physician and non-physician surgical providers. Responsibilities include:

• Primary diagnosis and procedural coding for designated major surgical specialty areas.
• Capture of applicable Physician Quality Reporting System (PQRS) and reconciliation of all surgical cases performed at each hospital.
• Focus on detailed physician surgical chart abstraction.
• Liaison to documentation improvement and optimization of physician coding practices for compliance and revenue purposes.
• Identification of codes based solely on source documentation for CPT and ICD-10-CM.

Work Performed

• Primary code from final surgical/procedural operative reports signed by the provider.
• Review complex medical records and accurately code primary/secondary diagnoses and procedures using ICD-10-CM and/or CPT coding conventions.
• Maintain understanding of anatomy and physiology, medical terminology, disease processes, and surgical techniques through continuing education.
• Correlate information from approved supporting clinical documentation after review by the attending physician.
• Provide education/training to physicians and other providers on coding and clinical documentation.
• Communicate with nursing and ancillary services personnel for needed documentation for accurate coding.
• Provide real-time feedback to surgical/procedural providers regarding proper coding and clinical documentation.
• Engage in provider/department contact and education as the primary liaison for documentation and coding clarification.
• Mentor and assist in the training of other coders within the department.
• Participate in the development of coding policies and procedures.
• Coordinate/mentor the work of designated coding employees to ensure quality and quantity of work performed through regular audits.
• Assist with research and development of presentation materials for continuing education programs for physicians.
• Interact with and provide high-level analysis of trends to management and Revenue Managers about coding-related issues.
• Research and identify trends in unbilled accounts.
• Contact appropriate personnel for clinical documentation inefficiencies.
• Coordinate quality reporting measures with providers and revenue managers/management (PQRS).
• Collaborate with appeal and edit coders for expedient resolution of accounts.
• Use authorized electronic media/systems for documentation, coding abstraction, and review of CCI edits, LCD and NCD coverage.
• Perform other related duties incidental to the work described herein.

Knowledge, Skills and Abilities

• Extensive knowledge of coding surgical procedures and applicable modifiers in a multi-specialty setting.
• Understanding and application of appropriate Center Medicare Services guidelines to coding.
• Advanced ICD-10-CM & CPT-4 coding conventions.
• Knowledge of anatomy and physiology.
• Medical terminology expertise.
• Extensive DRG/APC reimbursement knowledge.
• Coding software familiarity.
• Effective written and verbal communication skills.
• Data entry/CRT skills.

Minimum Qualifications

• Education: Bachelor degree in medical record administration or associate degree in medical record technology or one year coding diploma or courses in Medical Terminology, Anatomy & Physiology with extensive training in coding.
• Experience: Requires four years of coding experience, with at least two of those years in surgical abstraction.
• Degrees, Licensures, Certifications: Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) or Certified Professional Coder (CPC).

Benefits

• Now offering a $10,000 sign-on bonus that will pay out in 4 equal installments over 24 months - 6-month increments.