Coding Specialist III
2 days ago
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 accurate and complete coding of medical-professional services, based on extensive knowledge of regulatory and payer requirements.
Key Responsibilities- Abstract and ensure 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 associates.
- Assist in developing guidance to clinicians in optimizing dictations to promote compliance and claim processing.
- Assist in the maintenance of billing, coding, and edit dictionaries in the billing system.
- Consistently meet or exceed established Quality, Accuracy, and Productivity standards as defined by policies.
- 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 Coding Specialist I and II, including review and correction of code selection based on medical documentation.
- Handle complex coding case review, including surgical coding, extraction, co-surgery scenarios, multivisceral transplant cases, and comorbidity evaluation.
- Identify and report issues and trends in physician documentation and/or work routed to Coding from other departments.
- Identify coding trends relative to edits/denials/physician feedback.
- Maintain continuing education and credentials as required for job classification.
- Provide guidance to Coding Specialists I and II related to complex edit and appeal scenarios.
- Recommend policy and procedural changes and improvements for revenue enhancement.
- Survey Medical Professional Societies coding guidelines to ensure usage of current coding combinations and rationale.
- 5-7 years medical-professional coding experience with demonstrated ability to work independently.
- 2 years experience leading others or leading a work stream required.
- CPC (Certified Professional Coder) certification required.
- Bachelor's degree preferred.
- Demonstrated attention to detail accompanied by outstanding organizational skills.
- 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.
- Ability to toggle between specialty coding disciplines, including ancillary services, including Anesthesia, Emergency Medicine, Radiology, Pathology, and others.
- Verbal and written communication skills.
- Basic computer skills preferred.
MedStar Health offers a competitive salary range of $28.20 - $47.30 and a remote, full-time, day-shift schedule.
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