Sr. Specialty Physician Coder

Job Summary

The Senior Specialty Physician Coder reviews and analyzes specialty medical coding and billing to support accurate charge processing, reimbursement, and compliance. This role codes office, hospital, and surgical procedures across inpatient and outpatient services, works with clinical partners and contract coders, and helps identify coding trends, irregularities, and opportunities for improvement. The position also provides coding guidance, training, and mentoring to internal and external coding staff.

Key Responsibilities

• Review and accurately code office visits, hospital services, surgical procedures, diagnostic tests, and other medical services.
• Apply ICD-10, CPT, and HCPCS coding standards to support accurate billing and reimbursement.
• Review specialty coding and billing for compliance with applicable requirements and organizational policies.
• Support coding operations across inpatient and outpatient services.
• Serve as a primary contact for contract coders and help maintain continuity of coding operations.
• Implement and reinforce organizational coding policies and procedures.
• Collaborate with the Coding Compliance Manager to identify coding trends, irregularities, and required corrective actions.
• Research and resolve complex coding and billing issues.
• Work with physicians, clinical partners, and business center teams to clarify coding information and maintain positive working relationships.
• Train and mentor internal and external coding staff.
• Respond to coding-related questions and incoming calls and emails.
• Maintain confidentiality of patient information and other sensitive records.
• Use Epic and Microsoft Office applications to support coding and documentation workflows.
• Manage workload, prioritize tasks, and maintain accuracy and productivity in a changing healthcare environment.

Required Qualifications

• High school diploma or GED.
• At least 5 years of medical coding experience in a hospital or physician's office, including interaction with physicians.
• At least 2 years of specialty coding experience in one or more of the following areas:
  • Cardiothoracic Surgery
  • Surgical Oncology
  • Interventional Radiology
  • Oncology, Chemotherapy, or Infusion
• Expert knowledge of ICD-10, CPT, and HCPCS coding systems.
• Strong knowledge of medical terminology, anatomy, and physiology.
• One of the specified coding certifications: CPC, CCS, COC, CCC, CCVTC, or CIRCC.
• Proficiency in Microsoft Office applications.
• Strong analytical, critical-thinking, problem-solving, communication, and time-management skills.
• Ability to handle complex and confidential information appropriately.

Preferred Qualifications

• Experience using Epic software.
• Specialty coding certification.
• Experience training or mentoring coding staff.

Fountain Valley, California, United States

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