Description: The Senior Coder of Denials & Interventional Pain position
will be working directly with the Department of Anesthesia, Critical Care and
Job Location: Remote
Job Summary: Performs professional certified coding and
provides administrative and project support to the department. Analyzes
surgical-medical documentation, provides application of appropriate CPT and
ICD-10/CPT/HCPCS descriptor codes including the appropriate use of modifiers to
ensure compliance for reimbursement.
Coordinates coding across various divisions for both Interventional Pain and Anesthesia. Analyzes surgical
operative and other notes and documents to determine the scope and complexity
of the services provided.
Analyzes medical denials for determination of billing per
medical policy and coding rules.
Utilizes professional coding knowledge, applies CPT and ICD10/CPT/HCPCs codes to the services
delineated in the operative note. Reviews documentation and codes to ensure
appropriate capture of all billable services. Provides ongoing feedback and
education to the applicable clinical staff regarding appropriate documentation
and coding of services.
Acts as the key liaison for the clinical staff as it relates to
coding and compliance. Interacts with physicians and other professional staff
on documentation issues related to coding data.
Remains current with any changes in ICD-10 and CPT-4 coding and
remains current with Medicare, federal insurance and third-party billing
compliance regulations. Works collaboratively with the Director and coders to
ensure all the division charge tickets are compliant, accurate and updated
annually or as new procedures are added to the division.
Identifies accurate codes and categories for e-ticket
implementation for each division. Maintains accurate and current codes in the
system by working collaboratively with IS department. Maintains the department
Practice and Procedure manual and updates quarterly with new or modified
practices or procedures.
High School diploma or GED required
CPC and CANPC coding certification
5-7 years related work experience required, 8-10 preferred
Advanced skills with Microsoft applications which may include
Outlook, Word, Excel, PowerPoint or Access and other web-based applications.
May produce complex documents, perform analysis, and maintain databases.
Decision Making: Ability to make decisions that
are guided by precedents, policies and objectives. Regularly makes decisions
and recommendations on issues affecting a department or functional area.
Problem Solving: Ability to address problems that
are varied, requiring analysis or interpretation of the situation using direct
observation, knowledge and skills based on general precedents.
Independence of Action: Ability to follow precedents and
procedures. May set priorities and organize work within general guidelines.
Seeks assistance when confronted with difficult and/or unpredictable
situations. Work progress is monitored by supervisor/manager.
Written Communications: Ability to summarize and
communicate in English moderately complex information in varied written formats
to internal and external customers.
Oral Communications: Ability to comprehend and
communicate complex verbal information in English to medical center staff,
patients, families and external customers.
Knowledge: Ability to demonstrate in-depth knowledge of concepts, practices
and policies with the ability to use them in complex varied situations.
Teamwork: Ability to act as a team leader for small projects or work
groups, creating a collaborative and respectful team environment and improving workflows.
Results may impact the operations of one or more departments.
Customer Service: Ability to provide a high level
of customer service to patients, visitors, staff and external customers in a
professional, service-oriented, respectful manner using skills in active
listening and problem solving. Ability to remain calm in stressful situations.
Physical Nature of the Job:
Sedentary work: Exerting up to 10 pounds of force occasionally in carrying,
lifting, pushing, pulling objects. Sitting most of the time, with walking and
standing required only occasionally