Coding Specialist III - Neurosurgery

• Abstracts and ensures accuracy of diagnosis, procedure, patient demographics, and other required data elements.
• Aids in the creation of training and educational coding guidance documents for physicians and MMG Associates.
• Assists in developing guidance to clinicians in optimizing dictations to promote compliance and claim to process.
• Assists in the maintenance of billing, coding, and editing dictionaries in the billing system.
• Consistently meets or exceeds established Quality, Accuracy, and Productivity standards as defined by policies.
• Contacts physician when conflicting or ambiguous information appears in the medical record. Requests diagnosis from physicians when not recorded in medical records.
• Determines the sequence of diagnoses for accurate claims submission.
• Employs knowledge of coding compliance, and directs efforts to achieve quality standards identified through coding reviews or targeted by management for improvement.
• Guides and provides mentoring related to coding projects done by Coding Specialist I and Coding Specialist II to include review and correction of code selection based upon medical documentation.
• Handles complex coding case review, including but not limited to surgical coding (Orthopaedics, Cardiac, Neurosurgery, Otolaryngology, etc.) extraction, co-surgery scenarios, multi-visceral transplant cases, comorbidity evaluation.
• Identifies and reports issues and trends in physician documentation and/or work routed to Coding from other departments.
• Identifies coding trends relative to edits/denials/physician feedback.
• Maintains continuing education and credentials as required for job classification.
• Provides guidance to Coding Specialists I and II related to complex edit and appeal scenarios.
• Recommends policy and procedural changes and improvements for revenue enhancement.
• Surveys Medical Professional Societies coding guidelines to ensure the usage of current coding combinations and rationale.
• CUSTOM.PRIMARY.DUTIES.RESPONSIBILITIES.ADDENDUM

• High School Diploma or GED required; Bachelor's degree preferred
• Consideration will be given to appropriate combination of education, training and experience

• 5-7 years Medical-professional coding experience with demonstrated ability to work independently required
• 2 years experience leading others or leading a work stream required
• Experience with computer systems for encoding and abstracting required and
• Additional years of experience strongly preferred

• CPC (Certified Professional Coder) certification required

• Demonstrated attention to detail accompanied by outstanding organizational skills.
• Ability to interact effectively with physicians, liaisons, department administrators, and associates.
• Ability to work independently and practice self-direction.
• Working knowledge of payer policies, CMS policies, local and national regulatory and compliance policies; regular utilization of all available coding resources.
• Ability to toggle between specialty coding disciplines, including ancillary services, Anesthesia, Emergency Medicine, Radiology, Pathology and others.
• Verbal and written communication skills.
• Basic computer skills preferred.

MedStar Health