Physician Services Coding Specialist II – Remote (Pathology) – Conifer Health Solutions – Frisco, TX

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!

JOB SUMMARY

The primary purpose of the SPEC, PHYS SVC CODING II is to code physician charges by assigning ICD-9, CPT-4 & HCPC codes from documentation. Intermediate knowledge of level 1 & 2 modifiers is required. A SPEC, PHYS SVC CODING II must have the ability to utilize multiple websites to support code assignment be able to cite supporting documentation for coding compliance issues. A SPEC, PHYS SVC CODING IImust possess intermediate knowledge on how to problem-solve insurance rejections and denial issues. Coders are responsible for accurate and complete coding under Compliance Guidelines. Productivity and accuracy are measured via internal audits and must be maintained.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Assign ICD-9, CPT-4 & HCPC codes from documentation
• Problem-solve insurance rejections and denial issues
• Uphold productivity standards / daily quota set by management
• Maintain company accuracy rate of 95% in monthly internal audits
• Effectively present coding issues to internal or external clients; deliver information in a one-on-one or small group format to peers
• Meet deadlines and complete assignments before monthly closing dates
• Maintain strictest confidentiality
• Perform related work as required
• Others may be assigned.

Qualifications:

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment activity. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

EDUCATION / EXPERIENCE

• Vocational or technical education beyond high school
• Minimum of 1-2 years coding experience
• CPC or CCS-P or equivalent certification or related, relevant experience
• Demonstrate a good working knowledge of medical terminology, human anatomy, and coding
• Must possess knowledge of third party reimbursement regulations and billing practices
• Possess moderate knowledge of level 1 & 2 modifiers
• Ability to examine documents for accuracy and completeness
• Ability to understand and follow compliance issues of moderate complexity
• Detail oriented with the ability to identify and resolve problems
• Must possess moderate knowledge of CCI edits and LCDs and be able to accurately apply regulation knowledge to coding situations
• Radiology coders must be able to code the following modalities: level I, plus duplex and Doppler ultrasounds, CT’s/CTA’s, MRI’s, nuclear medicine, and basic IR procedures
• Multi-specialty coders must possess correct coding E&M and at least 2 other specialties
• Able to work TES (Transaction Editing System) edits of moderate complexity
• Ability to communicate clearly and work effectively with co-workers
• Ability to work as a team member in all activities
• Conduct self in an ethical, honest, and professional manner
• Demonstrate continued willingness to learn and grow
• Proficient in Microsoft Word, Excel

POSITION COMPETENCIES:

• Builds Team Relationships – Invites others to share opinions. Partners with employees in other departments. Actively seeks ways to help team members.
• Communicates Effectively – Expresses ideas clearly and succinctly with small or large audiences. Listens attentively to speaker’s message without interruption. Tailors writing to audience using correct grammar and spelling.
• Compliance with Laws, Policies and Procedures – Adheres to company handbook and policies. Demonstrates behavior consistent with Code of Conduct. Adheres to compliance program and guidelines.
• Develops Self – Seeks opportunities for continuous learning. Modifies behavior in response to feedback. Knows personal strengths and weaknesses and demonstrates ownership for personal development.
• Displays Adaptability – Performs well in high pressure or stressful situations. Works effectively when direction is unclear or rapidly changing. Demonstrates persistence in the face of obstacles.
• Drives for Results – Delivers high quality work and attains results. Demonstrates personal drive and pushes self and others for results and quality work. Response appropriately to urgent situations.
• Focus on the Customer/Client – Ensures that clients have a positive experience. Responds to clients in a timely manner. Demonstrates tact and empathy when responding to clients.
• Respects Others – Displays sensitivity to the needs and concerns of others. Interacts with others in an open, non-threatening manner.
• Shows Reliability – Takes personal responsibility for actions and decisions. Consistently works assigned schedule. Acts responsibly and can be counted on to accomplish goals successfully.

Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.