JOB SUMMARY

The primary purpose of the SPEC, PHYS SVC CODING II, is to code physician charges in multiple specialties for both EM and Surgical encounters by assigning ICD-9, CPT-4 & HCPC codes from medical record documentation. A SPEC, PHYS SVC CODING II must be knowledgeable on insurance and denial issues regarding coding and have the ability to follow compliance issues of difficult complexity by utilizing appropriate coding/compliance resources. A SPEC, PHYS SVC CODING II present coding issues to others and support the team as needed as a coach in specified situations.

EDUCATION / EXPERIENCE

• Vocational or technical education beyond high school
• Minimum of 3 years coding experience in relevant specialty

• Assign ICD-9, CPT-4 & HCPC codes from documentation; apply appropriate modifiers
• Problem-solve claim edits and support the denial process as requested.
• Uphold productivity standards / goals set by coding leaders and client contracts.
• Maintain coding quality accuracy rate of 95.5%
• Mentor and assist in new employee training
• Meet deadlines and complete assignments before monthly closing dates
• Demonstrate a good working knowledge of medical terminology, human anatomy, and coding
• Must possess knowledge of third-party reimbursement regulations and billing practices
• Ability to examine documents for accuracy and completeness
• Ability to understand and follow compliance issues of moderate complexity by utilizing appropriate coding/compliance resources
• Detail oriented with the ability to identify and resolve problems
• Must possess moderate knowledge of CCI edits and LCDs and be able to accurately apply regulation knowledge to coding situations
• Conduct self in an ethical, honest, and professional manner, demonstrate continued willingness to learn and grow
• Proficient in Microsoft Word, Excel
• Maintain strictest confidentiality
• Perform related work as required