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[Hiring] Physician Coding Specialist @Virtualstaffing ID - 10052

Role Description

The Physician Coding Specialist is responsible for analyzing medical records to ensure accurate and efficient coding practices, and compliance with regulatory standards. This role will have a subspecialty in lab billing, dermatology specific treatments, ASC billing, and cancer screening.

  • Review medical records and assign appropriate ICD-10, CPT, and HCPCS codes for all dermatology visits/procedures and diagnoses.
  • Ensure compliance with federal and state regulations, payer guidelines, including Medicare and Medicaid guidelines and company policies.
  • Assist with coding-related audits and compliance efforts.
  • Identify coding deficiencies by provider and practice and communicate this directly to the Medical Coding Auditor.
  • Work closely with Dermatology physicians, advanced practice providers, nurses, and administrative staff to ensure accurate coding and billing.
  • Analyze requirements, test systems, export data in EDI formats, and be able to load and transform EDI files into accessible data formats.
  • Document all analysis and reporting projects following established department protocols to ensure transparency and repeatability.
  • Create and operate within time-based workflows, ensuring charges are submitted within timely guidelines set by individual payers.
  • Maintain knowledge of existing and emerging regulatory changes and how they impact operational processes and beyond.
  • Collaborate with other departments and trading partners to research, identify and correct systemic data errors and ensure data is of the highest quality.
  • Collaborate with revenue cycle leadership to ensure compliance with all claims transmission.
  • Maintain professional relationships and collaborate across teams, managing projects, facilitating meetings and presenting in various settings, including senior leadership.

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Qualifications

  • Minimum of 3 years of experience in coding for dermatology procedures care is required.
  • 2+ years of experience in a remote working environment.
  • Must have a high school diploma or equivalent certificate.
  • Coding certification (e.g., CPC, CCS-P) required.
  • In-depth knowledge of ICD-10-CM, CPT, HCPCS coding systems, and medical terminology.
  • Hands-on experience having implemented 834 & 837 files for a health plan, build and troubleshoot carrier forms, and ensure accurate and efficient data exchange.
  • Proven ability to impact process improvement and efficient operations.
  • High level of business and technical knowledge with significant practical experience in healthcare administration or operations preferred.
  • Communicate effectively with internal staff and insurance companies.
  • Collaborative and humble approach with internal and external resources.
  • Able to prioritize and organize daily tasks.
  • Strong attention to detail, positive attitude and a proven ability to lead a team to success.
  • Proficient in Microsoft Word, Outlook and Excel.
  • Knowledge of state regulations.
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