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About Duke Health's Patient Revenue Management Organization
Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.
General Description
ion of the Job Class
The Medical Coder Specialist will have frequent and daily i nteractions with internal and external clients including but not limited to Physician and Non-physician Cardiology CATH/EP Prov iders. Responsibilities include diagnosis and procedural coding for the designatedmajor surgical specialty areas and other procedural areas including capture of professional services provided and reconciliation of al l surgical or procedural cases performed at each hospital where applicab le. The Medical Coder Specialist focuses their work on detailed physicia n procedural chart abstraction as well as serves as a liaison to documen tation improvement and optimization of physician coding practices for co mplianceand revenue purposes. Surgical and/or procedural abstraction cod ing is defined as code assignment based solely on the source documentati on for CPT -4 and ICD-10-CM respectively.
Duties and Responsibilities o f this Level
Primarily code from fina l procedural/ surgical operative reports signed by the provider. Review complexmedical records and accurately assigns codes for primary/secondar y diagnoses and procedures using ICD-10-CM and/or CPT-4 coding conventio ns. Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes and procedural/surgical techniques throu gh participation in continuing education programs to effectively apply I CD-10-CM and CPT-4 coding guidelines to inpatient and outpatient diagnos es andprocedures. Correlate information from approved supporting clinica l documentation not limited to Pathology, Radiology and/or other Physici an Consultations after review by the Attending Physician, wherever appro priate.
< p>Provide education/training to physicians and other providers on codingn coding practices and conventions in order to provide detailed co ding iand clinical documentation. Consult with and educate/train physici ans onformation. Communicate with nursing and ancillary services personn el for needed documentation for accurate coding. Provide real-time feedb ack to procedural/surgical providers as it pertains to proper coding and clinical documentation of services performed. Engage in provider/ departmentcontact and education as the primary liaison for clarification of d ocumentation and coding for defined surgical operative cases including d ocumentation deficiencies.
Mentor and assists in training of other coder s within the department. Participate in the development of coding polici es and procedures as identified. Coordinate/mentor the work of designate d coding employees to ensure quality and quantity of work performed thro ughregular audits. Assist with research and development of presentation materials for continuing education programs for physician in their areas ofspecialization.
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Interact with andprovides high-level analysis of tre nds to Management, Revenue Managers and others about Coding related issu es. Researches and identifies trends in unbilled accounts. Contacts appr opriate personnel for clinical documentation inefficiencies. Coordinate quality reporting measures w/ providers, revenue managers, and managemen t.Collaborate with appeal and edit coders to expedite resolution of acco unts. Use authorized resources and systems to aid inaccurate code assign ment for physician and non-physician documentation and surgical abstract ion. This may include but not limited to review of NCCI Edits, LCD's, NC D's, use of nThrive, and other reputable coding references
Perform other related duties incidenta lto the work described herein.
Minimum Qualifications
Education
Bachelor degree in medical record administration or associate degree in medical record technology or one year coding diploma or courses in Medical Terminology, Anatomy & Physiology with extensive training in coding.
Experience
Requires four years of coding experience, with at least two of those years in surgical abstraction (physician or medical group in multi- specialty surgical practices, i.e., Cardiothoracic Surgery, Neurosurgery, General Surgery, Orthopedics, etc.).
Degrees, Licensures, Certifications
Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) or Certified Professional Coder (CPC)
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Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.