Coding Specialist III - Plastics/Podiatric Surgery

General Summary of Position MedStar Health is looking for a Coding Specialist III with experience in Plastics/Podiatric Surgery coding to join our REMOTE team! To qualify for a level III Coding Specialist, you must have 5-7 years medical-professional coding experience and CPC certification. As a Coding Specialist III you will ensure that MedStar Health's medical-professional services are coded correctly and completely, based upon extensive, complete, up-to-date knowledge of regulatory and specific payer requirements. You will recommend policy and procedural changes to obtain optimum reimbursement for services rendered. Besides interacting with physicians on coding issues, you will keep physician encounter forms, the IDX billing system, and MMG processes up to date and compliant regarding coding issues. You will assist the manager as required and mentor and review the work of Coding Edit Specialists, Coding Specialist I and Coding Specialist II. Primary Duties: Abstracts and ensures accuracy of diagnosis, procedure, patient demographics, and other required data elements. Aids in the creation of training and educational coding guidance documents for physicians and MMG associates; assists in developing guidance to clinicians to optimize dictations and promote compliance and claim processing; assists in maintaining billing, coding, and editing dictionaries in the billing system. Contacts physicians when conflicting or ambiguous information appears in the medical record; requests diagnosis when not recorded. Determines the sequence of diagnoses for accurate claims submission; employs knowledge of coding compliance to achieve quality standards identified through coding reviews. Guides and provides mentoring on coding projects done by Coding Specialist I and II, including review and correction of code selection based on medical documentation. Handles complex coding case review, including surgical coding (Orthopaedics, Cardiac, Neurosurgery, Otolaryngology, etc.), co-surgery scenarios, multi‑visceral transplant cases, and comorbidity evaluation. Identifies and reports issues and trends in physician documentation and work routed to coding from other departments; identifies coding trends relative to edits, denials, and physician feedback. Recommends policy and procedural changes and improvements for revenue enhancement. Surveys medical professional societies coding guidelines to ensure the use of current coding combinations and rationale. Qualifications: High School Diploma or GED required; Bachelor's degree preferred. CPC (Certified Professional Coder) certification required. 5‑7 years medical‑professional coding experience with demonstrated ability to work independently. 2 years’ experience leading others or leading a work stream. Experience with computer systems for encoding and abstracting. Ability to interact effectively with physicians, liaisons, department administrators, and associates. Ability to work independently and practice self‑direction. Working knowledge of payer policies, CMS policies, local and national regulatory and compliance policies; regular utilization of all available coding resources. This position has a hiring range of $28.76 - $48.96. #J-18808-Ljbffr MedStar Health