Medical Coder Specialist

Overview

At Duke Health, we are driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

About Duke Health's Patient Revenue Management Organization

Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.

This position is 100% remote. All Duke University remote workers must reside in one of the following states:
North Carolina, Virginia, South Carolina, Tennessee, Florida, and Texas.

• The medical coder specialist will have frequent and daily interactions with internal and external clients, including but not limited to physicians and non-physician surgical providers.
• Responsibilities include primary diagnosis and procedural coding for the designated major surgical specialty areas and other major procedural areas, including the application of the Physician Quality Reporting System (PQRS) and confirmation of all surgical cases performed at each hospital where applicable.
• Focus on detailed physician surgical chart abstraction and act as an immediate liaison to documentation improvement and optimization of physician coding practices for compliance and revenue purposes for the providers in these areas.
• Statistical abstraction coding is defined as the identification of codes based solely on the source documentation for CPT and ICD-10-CM, respectively.
• Code from final surgical/procedural operative reports signed by the provider and review complex medical records to accurately code diagnoses and procedures using ICD-10-CM and CPT conventions (inpatient and outpatient).
• Maintain understanding of anatomy, physiology, medical terminology, disease processes, and surgical techniques through continuing education to apply coding guidelines.
• Correlate information from approved supporting clinical documentation (pathology, radiology, and/or other physician consultations) after review by the attending physician.
• Provide education and training to physicians and other providers on coding and clinical documentation.
• Consult with and educate/train physicians on coding practices and conventions to provide detailed coding information.
• 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 of services performed.
• Engage in practitioner/department contact and education as the primary liaison to clarification of documentation and coding for defined surgical operative cases, including documentation deficiencies.
• Mentor and assist in the training of coders within the department.
• Participate in the development of coding policies and procedures as identified.
• Coordinate/mentor the work of designated coding employees to ensure the quality and quantity of work through regular audits.
• Assist with research and development of presentation materials for continuing education programs for physicians in their areas of specialization.
• Interact with and provide high-level analysis of trends to management about coding-related issues; research trends in unbilled accounts.
• Contact appropriate personnel for clinical documentation inefficiencies; coordinate quality reporting measures with providers and revenue managers.
• Collaborate with appeal and edit coders to expedite resolution of accounts.
• Use authorized electronic media/systems for physician and non-physician clinician documentation, coding abstraction for each surgical procedure, review of CCI edits, LCD, and NCD coverage.
• Perform other related duties incidental to the work described herein.

• Extensive knowledge of coding surgical procedures and applicable modifiers in multi-specialty settings.
• Understands and applies appropriate Center Medicare Services guidelines to coding advanced ICD-10-CM & CPT-4 coding conventions.
• Anatomy and Physiology
• Medical Terminology
• Extensive DRG/APC reimbursement knowledge
• Coding software familiarity
• Effective written and verbal communication skills
• Data entry/CRT

• Education:
  
  Bachelor s 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 (physician or medical group in multi-specialty surgical practices).
• Degrees, licenses, and certifications: RHIA, RHIT, CCS, or CPC.

Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an…