Abstracts, analyzes, and assigns ICD-10-CM, CPT, HCPCS codes and appropriate modifiers for evaluation and management (E/M), minor and major procedures, and diagnostic tests using computerized or manual systems.
Researches and resolves complex coding and reimbursement issues to ensure accuracy, quality, and integrity of coding and billing practices.
Communicates with physicians, clinic leadership, and billing/coding teams regarding documentation improvement opportunities, code changes, and denial trends.
Maintains department-defined quality and productivity standards.
Primary duties
- Assign CPT, HCPCS, and ICD-10-CM codes for professional services based on medical record documentation.
- Focus on E/M, major procedures, and diagnostic tests in accordance with industry standards and EvergreenHealth policies.
- Meet department productivity and accuracy standards.
- Serve as a subject matter resource to physicians for complex surgical procedures.
- Evaluate patient coding inquiries to determine coding accuracy.
- Communicate with clinic managers regarding provider CPT code selection changes.
- Research coding denials from payers and draft appeal letters for complex surgical procedures and bundling issues.
- Identify and report trends in code changes, payer denials, missed revenue opportunities, and compliance risks.
- Communicate documentation improvement opportunities to physicians and clinic leadership.
- Provide coverage and backup for other coders as needed.
Additional responsibilities from ProFee I
- Assign CPT, HCPCS, and ICD-10-CM codes for professional services, primarily E/M, minor procedures, and diagnostic tests.
- Communicate with clinicians and support staff regarding provider CPT code selection changes.
- Research coding denials and draft appeal letters for Denial Management.
- Report trends in code changes, payer denials, missed revenue opportunities, and compliance risks.
- Communicate documentation improvement opportunities to the Professional Coding Supervisor.
- Perform other duties as assigned.
Requirements & Qualifications
Required
- High school diploma or GED
- Current professional coding credential: AAPC CPC or COC, PMI CMC, AHIMA CCS-P, CCS, RHIA, RHIT, or CCA
- Minimum 3 years of coding experience with 1 year in a surgical practice, or 1 year of coding experience plus current AAPC specialty surgical certification
- Satisfactory completion of general and specialty-specific coding skills assessment
- Proficient knowledge of medical terminology, ICD-10-CM, CPT, and HCPCS coding conventions
- Comprehensive knowledge of anatomy, physiology, and disease processes
- Expanded understanding of payer billing requirements
- Excellent written and verbal communication skills
- Must possess or achieve one of the listed AAPC specialty surgical certifications within 1 year of hire or transfer
Desired
- 5 years of coding experience in a surgical practice
Benefits & Perks
Benefits and perks
- Medical, vision, and dental insurance
- On-demand virtual health care
- Health Savings Account
- Flexible Spending Account
- Life and disability insurance
- Retirement plans 457(b) and 401(a) with employer contribution
- Tuition assistance for undergraduate and graduate degrees
- Federal Public Service Loan Forgiveness program
- Paid time off / vacation
- Extended Illness Bank / sick leave
- Paid holidays
- Voluntary hospital indemnity insurance
- Voluntary identity theft protection
- Voluntary legal insurance
- Pay in lieu of benefits premium program
- Free parking
- Commuter benefits
- Cafeteria & gift shop discount
Location
Washington, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
1 month ago
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