Contractor Medical Coder II (Breast & Plastic Surgery)

Job Responsibilities:

• Verify and sequence ICD-10, and or CPT/HCPCS codes from patient medical records and or procedure reports for submission.
• Understanding of hierarchy coding for ICD-10 coding as it relates to official guidelines and linking.
• Knowledge and ability on how to apply column 1 and 2 rules for ICD-10 coding.
• Understanding of CMS guidelines and how to navigate and research LCD (LOCAL COVERAGE DETERMINATION) and NCD (National Coverage Determination).
• Individuals must be able to communicate clearly and precisely with providers during the querying process.
• Knowledge of Medicare, Managed Care and Commercial Insurance guidelines for coding E&M, procedures and surgery cases.
• Ability to navigate electronic medical records as it relates to billing, coding, and insurance denials.
• Must be able to work denials for insurance follow-up and work collaboratively with Accounts Receivable Team.
• Coders are expected to review and submit sixty-four encounters per day or eight charts per hour, related to E&M's, procedures, testing, denials are five charts per hour.
• Knowledge and understanding of insurance denials as it relates to accounts receivable.
• Must be comfortable working professional office, hospital outpatient and inpatient services.
• Participate in client and SAVISTA staff meetings, trainings, and conference calls as requested and or required.
• Maintain current working knowledge of ICD-10 and/or CPT/HCPCS, modifiers, coding guidelines, government regulations, protocols, and third-party requirements regarding coding and/or billing.
• Participate in continuing education activities to enhance knowledge, skills and maintain current credentials.

Skills and Qualifications:

• An active AAPC (American Academy of Professional Coders) AHIMA (American Health Information Association) credentials CPC, CCS-P, CPC-H, or related specialty credential.
• 1-2+ years professional coding experience in a large academic medical setting is required.
• Experience in coding professional Interventional Radiology services is required.
• Knowledge of medical terminology, anatomy and physiology, and ICD-10 and CPT/HCPCS code sets.
• Ability to consistently code at 95% threshold for quality and accuracy while maintaining client specific and/or Savista production and or quality standards.
• Proficient computer knowledge including MS Office with ability to enter data, sort and filter excel files, (Outlook, word and excel.
• Excellent interpersonal and problem-solving skills with all levels internal and external customers.
• Outstanding organization skills and time management required.