Physician Complex Coder
Banner Health is looking for a motivated, experienced Physician Complex Coder with three years of general pediatric coding with multi-specialty experience to join our talented team. In this role, you will cover our pediatric providers within Banner and will be coding for complex charts including surgical procedures. Our profee coders need to be experienced and independent E/M coders. Production expectations depend on what is being coded; straight E/M, procedure, or a minimum of nine encounters per hour. Requirements include three years recent experience in pediatric Profee EM coding, specialty experience preferred, and must be currently certified through AAPC or Ahima. Please note, this is a complex role, requiring more than a CPC-A level certification.
The hours are flexible with the ability to work your 8-hour shift between 5am-7pm (Monday-Friday). This is a fully remote position and available if you live in the following states only: AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI & WY. Banner Health does provide equipment for you to stay in contact with your team. Although this is a remote position we do work as a team, supporting and educating as we learn together. Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader.
Position Summary:
- Evaluates medical records, provides clinical and surgical abstraction for the full range of complex and/or multispecialty surgical, procedural and E&M professional services in accordance with nationally recognized coding guidelines.
- Utilizes coding knowledge and expertise to support department projects, validation edits, and/or revisions.
Core Functions:
- Analyzes medical information from medical records. Accurately codes diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements.
- Abstracts clinical diagnoses, procedure codes, and documents other pertinent information obtained from the medical record into the electronic medical records.
- Provides quality assurance for medical records. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards.
- Compiles daily and monthly reports; tabulates data from medical records for research or analysis purposes.
- Able to identify validation edits and revision issues to ensure compliant coding.
- Recognizes and distinguishes complex diagnoses and procedures and has attention to detail to make needed corrections and ensure accurate coding, reimbursement, and compliance.
- Works independently under regular supervision. Uses specialized knowledge for accurate assignment of ICD/CPT codes according to national guidelines.
Minimum Qualifications:
- High school diploma/GED or equivalent working knowledge and specialized formal training equivalent to the two year certification course in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associate's degree in a related health care field.
- Requires at least one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist Physician (CCS-P), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT), in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Certification may also include a general area of specialty.
- Requires three or more years of complex professional coding experience within specialty.
- Must be able to work effectively and efficiently in a remote setting, utilizing common office programs, coding software, and abstracting systems.
Preferred Qualifications:
- Specialty Certification. Radiology Certified Coder (RCC) if employed in the Imaging space.
- Experience in a large, multi-system physician practice preferred.
- Additional related education and/or experience preferred.
Anticipated Closing Window (actual close date may be sooner): 2025-11-25