Coding Specialist III
4 days ago
Job Summary:
MedStar Health is seeking a highly skilled Coding Specialist III to join our team. As a key member of our coding team, you will be responsible for ensuring the accuracy and completeness of medical professional services coding.
Key Responsibilities:
- Abstract and ensure the accuracy of diagnosis, procedure, patient demographics, and other required data elements.
- Aid in the creation of training and educational coding guidance documents for physicians and healthcare professionals.
- Assist in developing guidance to clinicians in optimizing dictations to promote compliance and claim processing.
- Contact physicians when conflicting or ambiguous information appears in the medical record.
- Determine the sequence of diagnoses for accurate claims submission.
- Employ knowledge of coding compliance and direct efforts to achieve quality standards identified through coding reviews or targeted by management for improvement.
- Guide and provide mentoring related to coding projects done by junior coding specialists.
- Handle complex coding case review, including surgical coding and comorbidity evaluation.
- Identify and report issues and trends in physician documentation and/or work routed to coding from other departments.
- Recommend policy and procedural changes and improvements for revenue enhancement.
- Survey 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 healthcare professionals.
- 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.
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