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Billing Coder III

Key Facts

Remote From: 
Full time
Mid-level (2-5 years)
English

Other Skills

  • •
    Mentorship
  • •
    Quality Control
  • •
    Communication
  • •
    Analytical Skills
  • •
    Team Management
  • •
    Detail Oriented
  • •
    Relationship Building
  • •
    Problem Solving

Roles & Responsibilities

  • Proficient in assigning pathology CPT codes and ICD-10-CM diagnoses.
  • Knowledge of coding conventions, guidelines, and regulations governing government and third-party billing.
  • Experience with Xifin/LIS for coding edits and transactions.
  • Ability to assist in new-hire training and act as escalation point for teammates.

Requirements:

  • Research and assign pathology CPT codes and ICD-10-CM diagnoses based on review of the entire medical record.
  • Analyze and review detailed and highly complex code edits and transactions within Xifin/LIS.
  • Review coding-related denials for resolution and provide support to the billing staff by resolving complex cases and issues as assigned.
  • Assist in new-hire training and participate in testing and training of new system applications.

Job 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 III 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.
  • Assist in new hire training and escalation point for teammates.
  • Coding related denials 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.
  • Participate in the testing and training of new system applications.

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