Job Title: Specialty Physician Coder
Duration: 4 months with possible extension
Location:Fountain Valley, CA

Job Summary

Under the direction of the Coding Compliance Manager, the Specialty Physician Coder is responsible for reviewing and analyzing specialty coding and billing for charge processing. This role ensures accurate and compliant coding of office, hospital, surgical/procedural, inpatient, and outpatient services, diagnostic tests, and other medical services for reimbursement. The coder works closely with the Coding Compliance Manager to address coding trends, irregularities, and action items.

Key Responsibilities

• Meet productivity and quality standards established by management.
• Analyze medical records and accurately assign ICD-10-CM, CPT, and HCPCS codes according to coding guidelines.
• Review and natively code surgical operative and procedure reports.
• Work claim denials, Follow-Up work queues, and Claim Edit work queues to identify billing and coding improvement opportunities.
• Analyze denial trends and coding change reports to optimize reimbursement and compliance.
• Participate in coding compliance monitoring, benchmark comparisons, policy development, and physician documentation improvement initiatives.
• Provide coding education and ongoing communication to providers.
• Collaborate with Physician Billing Services Insurance and Customer Service Representatives to resolve billing and coding issues.
• Work weekly Missing Charge Reports to identify missed billable charges and maximize reimbursement.
• Organize, attend, and participate in specialty provider meetings; prepare presentations, document meeting minutes, and follow up on action items.
• Complete assigned projects and additional duties within the scope of knowledge and ability.
• Perform other duties as assigned.

Required Skills & Experience

• 3 years of experience as a medical coder in a hospital or physician office setting with physician interaction.
• 1 year of specialty coding experience in one of the following:
  • Cardiology
  • Gastroenterology
  • Medical Hematology/Oncology
  • OBGYN
  • Pulmonology
  • General Surgery
  • Radiation Oncology
• Proficiency with Microsoft Office Suite and Epic software.
• Expert knowledge of ICD-10, CPT, and HCPCS.
• Strong knowledge of medical terminology, anatomy, and physiology.
• Strong analytical, critical thinking, problem-solving, organizational, and time management skills.
• Strong understanding of the healthcare revenue cycle.
• Excellent communication, customer service, and interpersonal skills.
• Ability to prioritize, multitask, maintain confidentiality, and work collaboratively in a changing healthcare environment.
• Professional demeanor, strong work ethic, honesty, dependability, and adherence to company policies and procedures.
• Epic software experience.

Education

• High School Diploma or GED required.

Certifications & Licensure

Required

• AAPC Certified Professional Coder (CPC) OR
• AHIMA Certified Coding Specialist (CCS)

Preferred

• AAPC Certified Cardiology Coder (CCC)
• AAPC Certified Gastroenterology Coder (CGIC)
• AAPC Certified General Surgery Coder (CGSC)
• Specialty coding certification in a relevant specialty area.

 
 
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: $ 42.00/hr.