Physician-based Oncology Senior Complex Coder
- Phoenix, AZ
- $26.82-40.22 per hour
- Permanent
- Full-time
- Minimum 5 years recent experience in E/M Oncology coding (clearly reflected in your attached resume);
- Surgical Oncology experience preferred;
- Must be currently certified through AAPC or Ahima, as defined in minimum qualifications below. Please upload a copy or provide certification number in your questionnaire. Please note, this is a COMPLEX role, requiring more than a CPC-A level certification.
This position performs full range of complex professional coding in support of specialty or multi-specialty physician practices by evaluating medical records and validating that appropriate clinical diagnosis and procedure codes are assigned in accordance with nationally recognized coding guidelines. Utilize coding knowledge and expertise to support department projects, validation edits and revisions. Participates and leads in training and onboarding of new staff. Participates and leads coding round table discussions.CORE FUNCTIONS
1. Analyzes medical information from medical records. Accurately codes diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate coding in accordance to department specific productivity and quality standards. Codes ICD CM and CPT4 for accurate APC assignment. Addresses National Correct Coding Initiative (NCCI) edits as appropriate. Reconciliation of charges as required.2. Abstracts clinical diagnoses, procedure codes and documents other pertinent information obtained from the medical record into the electronic medical records. Seeks out missing information and creates complete records, including items such as disease and procedure codes, discharge disposition, date of surgery, attending physician, consulting physicians, surgeons and anesthesiologists, and appropriate signatures/authorizations. Refers inconsistent patient treatment information/documentation to coding quality analysts, supervisor or individual department for clarification/additional information for accurate code assignment.3. Provides quality assurance for medical records. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards.4. As assigned, compiles daily and monthly reports; tabulates data from medical records for research or analysis purposes.5. Able to identify validation edits and revision issues to ensure compliant coding.6. Recognizes and distinguishes complex diagnoses and procedures and has attention to detail to make needed corrections and ensure accurate coding, reimbursement, and compliance.7. Provides mentoring for less experienced staff members and act as subject matter experts for complex coding. Will assist in onboarding of new coders to include but not limited to daily functions, system training, policies and procedures.8. Works independently with the ability to manage and prioritize work assignments. Uses specialized knowledge to ensure accurate assignment of ICD/CPT codes according to national guidelines. Ability to address complex coding matters independently with regard to correct interpretation of coding guidelines and LCDs (Local Coverage Determinations) prior to referral to coding analyst, coding educator or coding manager/supervisor.MINIMUM QUALIFICATIONSHigh school diploma/GED or equivalent working knowledge and specialized formal training equivalent to the two year certification course in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associate’s degree in a related health care field.
- Requires at least one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician (CCS-P), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT), in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Certification may also include a general area of specialty.