PRMO: , established in 2001, Patient Revenue Management Organization (PRMO) is a fully integrated, centralized revenue cycle organization supporting all of Duke Health, including Duke University Hospital, Duke Regional Hospital, Duke Raleigh Hospital, the Private Diagnostic Clinic, and Duke PrimaryCare. The PRMO focuses on streamlining the revenue cycle through enhanced management of scheduling, registration, coding, HIM operations, billing, collections, cash management, and customer service. The Mission of the PRMO is delivering quality service by enhancing the patient experience, providing financial security, and preserving Duke's reputation and mission of advancing health together. Our Vision is to be recognized as a world class innovative revenue cycle organization that values our people, patients and performance.
MEDICAL CODER SPECIALIST - PB Coding Operations- Medicine/Radiology (4583)
Primarily code from final procedural/ surgical operative reports signed by the provid er for the department of Interventional Radiology. Review complex medica l records and accurately assigns codes for primary/secondary diagnoses a nd procedures using ICD-10-CM and/or CPT-4 coding conventions. Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes and procedural/surgical techniques through participat ion in continuing education programs to effectively apply ICD-10-CM and CPT-4 coding guidelines to inpatientand outpatient diagnoses and proced ures. Correlate information from approved supporting clinical documentat ion not limited to Pathology, Radiology and/or other Physician Consultat ions after review by the Attending Physician, wherever appropriate.
Provide education/training to physicians and other providers on coding and cl inical documentation. Consult with and educate/train physicians on codin g practices and conventions in order to provide detailed coding informat ion. Communicate with nursing and ancillary services personnel for neede d documentation for accurate coding. Provide real-time feedback to proce dural/surgical providers as it pertains to proper coding and clinical do cumentation of services performed. Engage in provider/ department contac t and education as the primary liaison for clarification of documentatio n and coding for defined surgical operative cases including documentatio n deficiencies.
Mentor and assists in training of other coders within the department. Participate in the development of coding policies and proce dures as identified. Coordinate/mentor the work of designated coding emp loyees to ensure quality and quantity of work performed through regular audits. Assist with research and development of presentation materials f or continuing education programs for physician in their areas of special ization.
Interact with and provides high-level analysis of trends to Man agement, Revenue Managers and others about Coding related issues. Resear ches and identifies trends in unbilled accounts. Contacts appropriate pe rsonnel for clinical documentation inefficiencies. Coordinate quality re porting measures w/ providers, revenue managers, and management. Collabo rate with appeal and edit coders to expedite resolution of accounts. Use authorized resources and systems to aid in accurate code assignment for physician and non-physician documentation and /procedure surgical abstr action. This may include but not limited to review of NCCI Edits, LCD's, NCD's, use of nThrive, and other reputable coding references.
Perform ot her related duties incidental to the work described herein.
Minimum Qualifications Education
Bachelor degree in medical record administration or associate degree in medical record technology or one year coding diploma or courses in Medical Terminology, Anatomy & Physiology with extensive training in coding.
Requires four years of coding experience, with at least two of those years in surgical abstraction (physician or medical group in multi- specialty surgical practices, i.e., Cardiothoracic Surgery, Neurosurgery, General Surgery, Orthopedics, etc.).
Degrees, Licensures, Certifications
Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) or Certified Professional Coder (CPC)
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