Physician Coding Review Specialist - REMOTE
Apply NowLocation:
US
Company:
Advocate Health is the third-largest nonprofit, integrated health system in the U.S., recognized for clinical excellence across numerous specialties.
Summary:
The Physician Coding Review Specialist is responsible for reviewing and ensuring accuracy in medical coding and documentation. The role requires advanced coding knowledge, relevant certifications, and significant experience in professional coding and clinician education.
Requirements:
Technology: Microsoft Office, electronic coding systems
Hard Skills: ICD coding, CPT coding, HCPCS coding, medical terminology, anatomy, physiology, data analysis, documentation review
Credentials: Coding Associate (CCA) certification, Coding Specialist - Physician (CCS-P) certification, Health Information Administrator (RHIA) registration, Health Information Technician (RHIT) registration, Professional Coder (CPC) certification, Specialty Coding Professional (SCP) certification, Specialty Medical Coding Certification
Experience: 5 years of experience in expert-level professional coding, 3 years of experience in the education of clinicians in physician revenue cycle processes
Job Description:
Physician Coding Review Specialist - REMOTE
Department: 10417 Enterprise Revenue Cycle - Coding & HIM Support Professional
Status: Full time
Benefits Eligible: Yes
Hours Per Week: 40
Schedule Details/Additional Information: Fully Remote
Major Responsibilities:
- Review assigned codes, which most accurately describe each documented diagnosis and/or procedure according to established CPT, HCPCS, and ICD-10-CM coding guidelines along with modifier usage and medical terminology. Monitor coding accuracy and maintain coding quality as needed.
- Review Clinician documentation and billed codes for Medical Group physicians and non-physician clinicians. Collaborate with Internal Audit, Compliance, and Clinic Operations.
- Follow the review plan to sample medical records for billing accuracy and provide feedback to Clinicians.
- Conduct timely reviews and generate reports on documentation/coding accuracy.
- Ensure compliance with the Clinician Documentation Review Plan and identify documentation issues needing improvement.
- Identify coding quality issues and recommend improvement strategies.
- Conduct regular reviews of coding accuracy and provide educational recommendations.
- Collaborate with interdepartmental teams and provide data-driven feedback to improve coding quality.
Licensure, Registration, and/or Certification Required:
- Coding Associate (CCA) certification by AHIMA, or
- Coding Specialist - Physician (CCS-P) certification by AHIMA, or
- Health Information Administrator (RHIA) registration by AHIMA, or
- Health Information Technician (RHIT) registration by AHIMA, or
- Professional Coder (CPC) certification by AAPC, or
- Specialty Coding Professional (SCP) certification by BMSC, and
- Specialty Medical Coding Certification by AAPC.
Education Required:
- Advanced training beyond High School in Medical Coding Specialist.
Experience Required:
- Typically requires 5 years of experience in professional coding and 3 years in clinician education in revenue cycle processes.
Knowledge, Skills & Abilities Required:
- Advanced knowledge of ICD, CPT, and HCPCS coding guidelines.
- Advanced knowledge of medical terminology, anatomy, and physiology.
- Ability to analyze trends and data for reporting.
- Effective training capabilities.
- Intermediate computer skills including Microsoft Office and electronic coding systems.
- Ability to work independently and meet deadlines in a fast-paced environment.
Pay Range: $26.10 - $39.15
