Coder - Anesthesia

POSITION SUMMARY:

The Physician Practice Coder-Anesthesia position is responsible for reviewing documentation in the outpatient/inpatient EHR. This position is responsible for assigning ICD-10-CM diagnosis codes and CPT, ASA, HCPCS II and appropriate modifiers to patient records from BMC Anesthesia Departments.  The Physician Practice Coder II Anesthesia position is a resource for the physicians and other health care providers in regard to coding and to review medical documentation to insure appropriate physician coding and billing.

Conducts CPT and ICD-10 coding reviews by detailed examination of each line item in the physician medical record and charge session.  Performs chart audits to ensure correct coding and charge capture have been applied appropriately.  Works closely with key revenue cycle stakeholders to understand reasons for denials, root cause analysis, and feedback to providers.

Position: Coder-Anesthesia        

Department: BUMG Corporate PBO General

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

• Perform coding and related duties of moderate and high complexity anesthesia work using established guidelines in an accurate and timely manner.

• Review medical documentation and system generated charges or paper encounter forms. Appropriately assign CPT, ASA, ICD-10, HCPCS II, and modifiers based on documentation and payor requirements

• Research billing rules and regulations for moderately complex new and existing procedures

• Demonstrate a commitment to integrating coding compliance standards into daily coding practices. Identify, correct and report coding problems.

• Maintains knowledge of coding and professional skills, including maintaining yearly coding credentials through attendance at in-service programs, conferences, workshops, review of current literature and other educational programs.

• Resolves complex coding edits and denials in a timely manner. Identify opportunities to reduce denials and enhance revenue.

• Provide cross coverage of multiple specialties

• Function as a resource to external customers. Research and resolve complex coding inquiries. Make recommendations for coding policy changes.

• Perform peer to peer quality assurance reviews of all Physician Practice Coders in equal or lower complexity areas of expertise

• Functions as subject matter expert for assigned specialties

• Develop and maintain division specific coding procedures and/or billing area instructions

• Complete special projects as assigned by manager.

• Participate in coding education for providers and co-workers upon request.

• Maintain coding certification.

• Sequences diagnoses, procedures and complications by following ICD-10-CM, Medicare, Medicaid, and other fiscal intermediary guidelines.

• Maintains productivity standards set forth in Departmental Policies and procedures. 

• Review and respond to coding questions. 

• Ensure billed service is being accurately coded.

• Perform random chart audits. 

• Performs other duties as needed. IND12

• Must adhere to all of BMC’s RESPECT behavioral standards.

JOB REQUIREMENTS

EDUCATION:

• Associates Degree (or direct work experience equivalent to at least 2 years).

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

• Coding Certification from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) is required. Certification may include CPC, COC, COC-A, CANPC, CGSC, CIC, CCA, CPC-A, CCS, CCS-P, RHIT, or RHIA

EXPERIENCE:

• Minimum of 2 years experience conducting Anesthesia coding/auditing in a surgical/procedural environment to include compliance, and billing processes.

KNOWLEDGE AND SKILLS:

• Advanced Proficiency in ICD-10, CPT, ASA, HCPCS, and modifiers for coding of professional fee services.

• Advanced knowledge of anatomy and physiology, medical terminology and insurance reimbursement policies and regulations.

• Excellent written and verbal communication skills and the ability to prioritize and organize work to meet strict deadlines are required.

• Able to code moderate/high complexity work.

• Understands, retains, and is able to research coding billing rules, regulations, and requirements.

• Able to critically think through processes in coding to recognize errors and/or problems. Understands reasons for actions on edits.

• Able to share/transfer kn