Billing Coder II

Description

About Us

Inform Diagnostics, a Fulgent Genetics Company, is a nationally recognized diagnostics laboratory focused on anatomic pathology subspecialties including gastrointestinal pathology, dermatopathology, urologic pathology, hematopathology, and breast pathology.

Founded in 2011, our parent entity, Fulgent Genetics, has evolved into a premier, full-service genomic testing company built around a foundational technology platform.

Through our diverse testing menu, Fulgent is focused on transforming patient care in oncology, anatomic pathology, infectious and rare diseases, and reproductive health. We believe that by providing a wide range of effective, flexible testing options in conjunction with best-in-class service and support, we can redefine the way medicine is managed for patients and clinicians alike.

Since integrating with our therapeutic development business, Fulgent is also developing drug candidates for treating a broad range of cancers using a novel nanoencapsulation and targeted therapy platform. By merging our fields of expertise, we aim to become a fully integrated precision medicine company.

Summary of Position

Each Billing Coder II is responsible for documentation review, coding, and data abstracting of medical service documentation to ensure the company receives appropriate reimbursement and conforms to applicable guidelines and regulations. Patients and their needs are our primary focus, so developing and sustaining productive member relationships is key to success.

Key Job Elements

• Research and assign pathology procedures (CPT) and diagnosis (ICD-10CM) codes based on review of the entire medical record.
• Analyze and review detailed and highly complex code edits and transactions within Xifin/LIS.
• Provide support to the billing staff by resolving complex cases and issues as assigned.
• Coding-related denial review for resolution.
• Contribute to the development and maintenance of specialized educational materials.
• Maintain current knowledge of coding conventions, guidelines, and regulations governing government and third-party billing to ensure that coding and documentation meets regulatory guidelines and audit standards.
• Meet department quality and production standards.

Qualifications

Knowledge/Experience

• High School diploma or equivalent required.
• 6 years of medical coding experience OR 4 years of anatomic pathology coding experience required.
• Ability to proficiently use Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-10) codes to ensure reliable communication with all physicians, insurance companies, and other healthcare providers.
• Working knowledge of CPT, HCPCS, and ICD.
• Certified Professional Coder Certification - CPC through AAPC.
• Demonstrated ability to abstract and assign all codes to pathology services performed.
• Ability to work in a fast-paced, deadline-driven environment.
• Working knowledge of resolving coding-related denials caused by MUE Edits, CPT codes, ICD codes, or modifiers.
• Excellent written and oral communication.
• Proficient in Microsoft Office Suite, specifically Word, Excel, and Outlook, and general working knowledge of the Internet for business use

Environment

At Inform Diagnostics, we celebrate, support, and thrive on our differences. We are proud to be an equal opportunity workplace and an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or veteran status. This description only includes the general content for this job and does not restrict the company from assigning or reassigning duties or responsibilities at any time.

For California residents, please see the link below to access our CCPA Privacy Notice.

CCPA Privacy Notice for California Residents

https://tinyurl.com/FulgentCCPA