VCU Health System Business Office Coding Services is seeking a full time Medical Coder III. The Medical Coder III translates authenticated provider documentation and/or operative reports and makes the determination as to the appropriate CPT, ICD-9/10 codes for billing of services rendered by providers for specialized complex coding from surgical and operative notes or from complex clinical specialties. Must comply with all applicable State, Federal and insurance regulations and guidelines in order to apply codes for consultation, diagnosis, surgical procedures, etc. Identifies, analyzes and resolves assigned denial payment issues according to established departmental policies and procedures or assists in resolving all coding associated payer denials by pulling charts, missing operative reports and gathering information requested by insurance company and/or supervisor. Assists in the resolution of payment denials, or independently resolves selected denials.
- Make independent decisions regarding documentation and accurate CPT-4 and ICD-10 PCS code assignments.
- Coordinate training/education and orientation of coding staff as well as performing managerial responsibilities related to interviewing potential candidates for hire, development of training programs, monitoring quality and productivity, payroll and performance reviews.
- Actively manage coding vendor contracts and relationships by establishing and/or ensuring the achievement of Service Level Agreements (SLA).
- Work with the Director and other professional services leaders on clinical documentation improvement, accuracy, revenue integrity, process efficiencies, effectiveness, and quality within the Professional Services Revenue Cycle
- Structure and deliver education and feedback to physicians and other professional billing professionals on documentation and billing issues.
- Bachelor’s Degree in Health Information Management, Business, Health Care Administration, Finance or closely related field from an accredited program
- Certified Professional Coder (CPC) by the American Association of Professional Coders
- Minimum of five (5) years physician practice professional coding experience with ICD-9, ICD10; and
- CPT coding principles and rules, reimbursement, documentation requirements and compliance
- Three (3) years management/supervisory experience
- Previous experience working with managed care companies
- Previous experience at the intermediate to advanced level with windows based software applications (Microsoft Word, Excel, PowerPoint, and Outlook), encoder software and e-mail applications
- Master’s Degree in Health Information Management, Business, Healthcare Administration, Allied Health Program or closely related field from an accredited program
- Seven (7) years previous physician practice coding experience in an acute care, Level I Trauma facility or other closely related field
- Previous experience with governmental and insurance regulations including coding and compliance issues
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The job Req# is 55125.
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