Job Title: OP Ancillary / Physician Coder (ProFee – Radiology)
Duration: 4 months with possible extensions 
Location: Fountain Valley, CA

Position Summary:
Under the direction of the Coding Compliance Manager, the OP Ancillary/Physician Coder will play a key role in reviewing and analyzing billing and coding for charge processing. This role will be responsible for reviewing and accurately coding office, hospital, and surgical procedures for reimbursement, as well as ensuring accurate and compliant medical coding for both inpatient and outpatient services, diagnostic tests, and other medical services rendered to each patient.

Responsibilities:

•  Possess analytical skills.
•  Possess critical thinking and problem-solving skills.
•  Solid understanding of the health care revenue cycle.
•  Strong communication skills with the ability to communicate information accurately and clearly.
•  Provide excellent customer service.
•  The ability to manage interpersonal relationships and effectively communicate with clinical partners and fellow business center teams.
•  Detail oriented.
•  Strong work ethic, honest, and dependable.
•  Collaborative team player with the ability to adapt to the ever-changing healthcare environment.
•  Professional demeanor at all times.
•  Maintain patient confidentiality.
•  Maintain a safe and orderly work area.
•  Personal time management skills – the ability to organize, prioritize, and multitask.
•  Achievement of productivity standards as established by management.
•  Achievement of quality standards as established by management.
•  Analyze and interpret medical information in the medical record and assign and sequence the correct ICD-10-CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient and/or outpatient medical records according to established coding guidelines.
•  Follow established workflow for working claim denials in the Follow-Up work queues and identify opportunities for billing/coding improvements.
•  Participate in developing, implementing, and reviewing programs for coding compliance monitoring, criteria for benchmark comparisons, organizational policies and procedures, and physician clinical documentation improvement programs.
•  Optimization opportunities include, but are not limited to, work in the Follow-Up and Claim Edit work queues and analyzing denial trends.
•  Follow Coding Compliance department branding standards when communicating with clinical partners and fellow business center teams, and work collaboratively with Physician Billing Services -Insurance and Customer Service Representatives to solve billing and coding issues.
•  Perform monthly coding change report analysis/oversight on provider coding change trends and communicate/educate providers, as needed.
•  Work weekly Missing Charge Reports to identify missed billable charges to maximize reimbursement.
•  Be at work and be on time.
•  Follow company policies, procedures and directives.
•  Interact in a positive and constructive manner.
•  Prioritize and multitask.
•  Other duties as assigned.

Required Skills & Experience:

•  Three (3) years’ experience working in a hospital or physician’s office as a medical coder and interacting with physician.
•  Expert knowledge of ICD10, CPT and HCPCS.
•  Strong knowledge of medical terminology, anatomy and physiology.
•  Proficient Microsoft skills.
•  Must reside in California (role will transition to FTE)
•  Minimum 3 years of experience as a physician/professional fee coder
•  Strong expertise in diagnostic radiology coding and bundling rules
•  Radiology experience required
•  Knowledge of charge submission within EPIC
•  ProFee coding only – No HCC coders
•  Epic software experience.

Education:

•  High school diploma or GED.
•  Associate's degree.

Required Certifications & Licensure:

•  CPC, CCS or equivalent certification offered by the AAPC and AHIMA.

 
 
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 36.00/daily.