Senior Physician Coder

ROLE REQUIREMENTS**

• Surgical breast oncology (including plastic reconstructive breast surgery) Hematology/Oncology
• Must be able to abstract the chart review to capture all billable charges
• Strong chemotherapy and infusion experience
• CHONC coding certification is highly desire
• EPIC experience: charge entry and charge review experience required
• Strong Evaluation and Management (E/M) inpatient and outpatient coding experience
• Must reside in CA
• Profee ONLY NOT HCC/risk adjustment ASC or facility coding
• Desire to convert to full-time employment

**Bonus/nice to have**

• Bonus: GYNONC coding experience
• Bonus: Experience working on denials
• Bonus: GI (CGIC coding certification) or OBGYN (COBGC coding certification) coding experience (1 year or more)

Under the direction of the Coding Compliance Manager the Specialty Physician Coder plays a key role
in reviewing and analyzing specialty coding and billing for charge processing. This role will be
responsible for reviewing and accurately coding office hospital and surgical/procedures for
reimbursement and ensuring accurate and compliant medical coding for inpatient and outpatient
services diagnostic tests and other medical services rendered to patients. The Specialty Physician
Coder will also work with the Coding Compliance Manager on discovered coding trends and
irregularities and needed action items.
Essential Functions and Responsibilities of the Job
1. Proficient in Microsoft Office suite.
2. Proficient in Epic software.
3. Strong analytical skills.
4. Strong critical thinking skills.
5. Detail oriented.
6. The ability to anticipate research and resolve problems/strong problem-solving skills.
7. Strong understanding of the healthcare revenue cycle.
8. Excellent communication skills with the ability to communicate information accurately and clearly.
9. The ability to manage interpersonal relationships and effectively communicate with clinical partners
and fellow business center teams.
10. Provide excellent customer service and address a moderate amount of incoming email and phone
calls.
11. Collaborative team player with the ability to adapt to the ever-changing healthcare environment.
12. Professional demeanor at all times.
13. The ability to handle complex and confidential information with discretion.
14. Maintain patient confidentiality.
15. Maintain a safe and orderly work area.
16. Strong work ethic honest and dependable.
17. Strong personal time management skills.
18. Be at work and be on time.
19. Follow company policies procedures and directives.
20. Interact in a positive and constructive manner.
21. Prioritize and multitask.

1. Achievement of productivity standards as established by management.
2. Achievement of quality standards as established by adherence with standard work
analyze and interpret medical information in the medical record and assign and sequence the
correct ICD-10-CM CPT and/or HCPCS codes to the diagnoses/procedures of office inpatient
and/or outpatient medical records according to established coding guidelines including the ability
to review and natively code surgical operative and/or procedure reports.
3. In adherence with standard work follow established workflow for working claim denials in the
Follow-Up work queues and identify opportunities for billing/coding improvements. Participate in
developing implementing and reviewing programs for coding compliance monitoring criteria for
benchmark comparisons organizational policies and procedures and physician clinical
documentation improvement programs. Optimization opportunities include but are not limited to
working in the Follow-Up and Claim Edit work queues and analyzing denial trends.
4. In adherence with standard work provide ongoing and frequent communication/education to
MCMF providers to maximize coding compliance and reimbursement. Follow Coding Compliance
department branding standards when communicating with clinical partners and fellow business
center teams and work collaboratively with Physician Billing Services Insurance and Customer
Service Representatives to solve billing and coding issues. Perform monthly coding change report
analysis/oversight on provider coding change trends and communicate/educate the providers as
needed.
5. In adherence with standard work work weekly Missing Charge Reports to identify missed billable
charges to maximize reimbursement.
6. In adherence with standard work organize attend and participate in specialty provider meetings.
Prepare presentation materials for meetings document meeting minutes follow up on important
action items/decisions from meetings and report to the Coding Compliance Manager.
7. In adherence with standard work take responsibility for various projects as assigned by
management and perform any additional/miscellaneous duties (not inclusive of job description) as
requested by the management team within the scope of knowledge/ability.
8. Other duties as assigned.

Experience
3 years experience working in a hospital or physicians office as a medical coder and interacting
with physicians.
1 years experience as a specialty coder in one of the following specialties: Cardiology
Gastroenterology Medical Hematology/Oncology OBGYN Pulmonology General Surgery or
Radiation Oncology.
Expert knowledge of ICD10 CPT and HCPCS.
Strong knowledge of medical terminology anatomy and physiology.
Epic software experience is highly desired.
Proficient Microsoft skills.

High School diploma or GED required.