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About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle.
It includes scheduling, registration, coding, billing, and other essential revenue functions.
Job Summary The Medical Coder Specialist will have frequent and daily interactions with internal and external clients, including physicians and non‑physician surgical providers. This role focuses on primary diagnosis and procedural coding for major surgical specialty areas and other major procedural areas, capturing applicable Physician Quality Reporting System (PQRS) and reconciling all surgical cases performed at each hospital where applicable. The specialist abstracts physician surgical charts, liaisons with documentation improvement teams, and optimizes coding practices for compliance and revenue.
Responsibilities and Work Performed
Primarily code from final surgical/procedural operative reports signed by the provider.
Review complex records, research references, and accurately code diagnoses and procedures using ICD‑10‑CM and CPT conventions.
Maintain a thorough understanding of anatomy, physiology, disease processes, and surgical techniques through continuing education.
Correlate information from approved supporting clinical documentation (pathology, radiology, consultations) after review by the attending physician.
Provide education and training to physicians and other providers on coding and documentation.
Consult and train physicians to improve coding practices and provide detailed coding information.
Communicate with nursing and ancillary staff for required documentation.
Provide real‑time feedback on proper coding and clinical documentation of services performed.
Engage as the primary liaison for documentation and coding clarification for surgical operative cases.
Mentor and assist in training other coders in the department.
Participate in the development of coding policies and procedures.
Coordinate and mentor coding employees to ensure quality and quantity through audits.
Assist with research and development of training materials for physicians.
Provide high‑level analysis of coding trends to management and revenue managers.
Identify trends in unbilled accounts and address clinical documentation inefficiencies.
Coordinate quality reporting measures with providers and revenue managers (PQRS).
Collaborate with appeal and edit coders to expedite account resolution.
Use electronic media/systems for documentation, coding abstraction, review of edits, coverage, and other incidental duties.
Knowledge, Skills, and Abilities
Extensive knowledge of coding surgical procedures, applicable modifiers in a multi‑specialty setting.
Understanding and application of Center Medicare Services guidelines to advanced ICD‑10‑CM & CPT‑4 conventions.
Knowledge of anatomy, physiology, medical terminology.
Extensive DRG/APC reimbursement knowledge.
Familiarity with coding software.
Effective written and verbal communication skills.
Data entry and computer literacy.
Education
Bachelor's degree in Medical Record Administration or associate degree in Medical Record Technology.
One year coding diploma or courses in Medical Terminology, Anatomy & Physiology with extensive training in coding.
Experience
Requires four years of coding experience, with at least two of those years in surgical abstraction in multi‑specialty surgical practices (e.g., cardiothoracic, neurosurgery, general surgery, orthopedics).
Degrees, Licensures, Certifications
Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) or Certified Professional Coder (CPC).
Equal Opportunity Employment Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation, or military status.
Essential Physical Job Functions Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
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About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle.
It includes scheduling, registration, coding, billing, and other essential revenue functions.
Job Summary The Medical Coder Specialist will have frequent and daily interactions with internal and external clients, including physicians and non‑physician surgical providers. This role focuses on primary diagnosis and procedural coding for major surgical specialty areas and other major procedural areas, capturing applicable Physician Quality Reporting System (PQRS) and reconciling all surgical cases performed at each hospital where applicable. The specialist abstracts physician surgical charts, liaisons with documentation improvement teams, and optimizes coding practices for compliance and revenue.
Responsibilities and Work Performed
Primarily code from final surgical/procedural operative reports signed by the provider.
Review complex records, research references, and accurately code diagnoses and procedures using ICD‑10‑CM and CPT conventions.
Maintain a thorough understanding of anatomy, physiology, disease processes, and surgical techniques through continuing education.
Correlate information from approved supporting clinical documentation (pathology, radiology, consultations) after review by the attending physician.
Provide education and training to physicians and other providers on coding and documentation.
Consult and train physicians to improve coding practices and provide detailed coding information.
Communicate with nursing and ancillary staff for required documentation.
Provide real‑time feedback on proper coding and clinical documentation of services performed.
Engage as the primary liaison for documentation and coding clarification for surgical operative cases.
Mentor and assist in training other coders in the department.
Participate in the development of coding policies and procedures.
Coordinate and mentor coding employees to ensure quality and quantity through audits.
Assist with research and development of training materials for physicians.
Provide high‑level analysis of coding trends to management and revenue managers.
Identify trends in unbilled accounts and address clinical documentation inefficiencies.
Coordinate quality reporting measures with providers and revenue managers (PQRS).
Collaborate with appeal and edit coders to expedite account resolution.
Use electronic media/systems for documentation, coding abstraction, review of edits, coverage, and other incidental duties.
Knowledge, Skills, and Abilities
Extensive knowledge of coding surgical procedures, applicable modifiers in a multi‑specialty setting.
Understanding and application of Center Medicare Services guidelines to advanced ICD‑10‑CM & CPT‑4 conventions.
Knowledge of anatomy, physiology, medical terminology.
Extensive DRG/APC reimbursement knowledge.
Familiarity with coding software.
Effective written and verbal communication skills.
Data entry and computer literacy.
Education
Bachelor's degree in Medical Record Administration or associate degree in Medical Record Technology.
One year coding diploma or courses in Medical Terminology, Anatomy & Physiology with extensive training in coding.
Experience
Requires four years of coding experience, with at least two of those years in surgical abstraction in multi‑specialty surgical practices (e.g., cardiothoracic, neurosurgery, general surgery, orthopedics).
Degrees, Licensures, Certifications
Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) or Certified Professional Coder (CPC).
Equal Opportunity Employment Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation, or military status.
Essential Physical Job Functions Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
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