Medical Coding Expert

4 days ago


Columbia, South Carolina, United States Medstar Full time
MedStar Health is seeking a skilled Coding Specialist III to join our remote team. As a key member of our coding team, you will be responsible for ensuring the accurate and complete coding of medical services. This role requires a strong understanding of regulatory and payer requirements, as well as the ability to work independently and make recommendations for policy and procedural changes to optimize reimbursement. The ideal candidate will have 5-7 years of medical-professional coding experience, a CPC certification, and the ability to interact effectively with physicians, liaisons, and department administrators. In addition to coding, you will also be responsible for mentoring and reviewing the work of junior coding specialists, as well as assisting with the creation of training and educational coding guidance documents. If you have a strong background in medical coding and are looking for a challenging and rewarding role, we encourage you to apply.

**Key Responsibilities:**

* Abstract and ensure the accuracy of diagnosis, procedure, patient demographics, and other required data elements
* Aids in the creation of training and educational coding guidance documents for physicians and MMG Associates
* Assists in developing guidance to clinicians in optimizing dictations to promote compliance and claim to process
* Contacts physician when conflicting or ambiguous information appears in the medical record
* Determines the sequence of diagnoses for accurate claims submission
* Employs knowledge of coding compliance, and directs efforts to achieve quality standards identified through coding reviews or targeted by management for improvement
* Guides and provides mentoring related to coding projects done by Coding Specialist I and Coding Specialist II to include review and correction of code selection based upon medical documentation
* Handles complex coding case review, including but not limited to surgical coding (Orthopaedics, Cardiac, Neurosurgery, Otolaryngology, etc.) extraction, co-surgery scenarios, multi-visceral transplant cases, comorbidity evaluation
* Identifies and reports issues and trends in physician documentation and/or work routed to Coding from other departments
* Identifies coding trends relative to edits/denials/physician feedback
* Recommends policy and procedural changes and improvements for revenue enhancement
* Surveys Medical Professional Societies coding guidelines to ensure the usage of current coding combinations and rationale

**Requirements:**

* High School Diploma or GED required; Bachelor's degree preferred
* CPC (Certified Professional Coder) certification required
* 5-7 years Medical-professional coding experience with demonstrated ability to work independently required
* 2 years' experience leading others or leading a work stream required
* Experience with computer systems for encoding and abstracting required
* Ability to interact effectively with physicians, liaisons, department administrators, and associates
* Ability to work independently and practice self-direction
* Working knowledge of payer policies, CMS policies, local and national regulatory and compliance policies; regular utilization of all available coding resources

**About MedStar Health:**

MedStar Health is one of the largest healthcare systems in the Baltimore-Washington metro region, recognized as one of the "Healthiest Maryland Businesses". We offer a dynamic and supportive work environment, with opportunities for professional growth and development. If you are a motivated and detail-oriented individual with a passion for medical coding, we encourage you to apply for this exciting opportunity.

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