Grady Health System · 2 weeks ago
PB Coder III
Atlanta, GA
Full-time
Onsite
Mid, Senior Level
4+ years expGrady Health System is seeking a PB Coder III responsible for coding and abstracting procedural and diagnosis codes for physician services. The role involves reviewing physician documentation, providing feedback, and ensuring proper code assignment while maintaining compliance with hospital and payer policies.
Health CareHospitalMedical Device
Responsibilities
Codes highly complex surgical, special procedures, observation records, inpatient records, medical, diagnostic, procedural, and/or recurring records within established productivity and coding accuracy guidelines. Highly complex surgeries may require research and reference checking to ensure accuracy of problematic coding
Evaluates medical record documentation, paper charge, discharge disposition, ICD-10 and CPT coding to optimize reimbursement by ensuring that medical, diagnostic and procedural codes and other documentation accurately reflect and support the visit
Compiles necessary documentation prior to coding review; when documentation is not available, performs the appropriate steps to obtain the necessary documentation per the department’s policies and procedures
Maintain the knowledge necessary to navigate the EeMR to efficiently perform tasks and meet production and quality standards
Assist manager in training of subordinate coders and serves as the point person/lead for employee questions
Works independently to resolve issues, applying root cause analyses to determine steps required for timely resolution. Meets established productivity and accuracy standards
Demonstrate the ability to communicate effectively and professionally in interactions with physicians, management, and staff
Queries physicians when code assignments are not straightforward or documentation is inadequate, ambiguous, or unclear for coding purposes; offers physician opportunity to submit corrected documentation
Notifies appropriate individuals of potential non-compliance with Medical Necessity requirements and when services are non-covered or not payable, as appropriate
Corrects failed claim errors to billing edits, coding denials, quality management data edits and/or other errors identified through various auditing or billing process
Maintains professional growth by participating in educational programs and professional organization to stay abreast of code changes, trends, practices, and developments. Must meet all requirements to maintain coding certification
Must be able to work collaboratively and positively within a culturally diverse production environment
Performs other duties as assigned
Qualification
Required
High School Diploma/GED required
Four (4) years of coding experience required
Two (2) years of experience must be in a Surgical/Ancillary Diagnostic discipline or 1 year of experience with specialty coding certification in a Surgical/Ancillary Diagnostic discipline
Knowledge of CPT and ICD-10 coding conventions
CPC, CCS, CPC-H, CCS-P, CCS-H, RHIA, RHIT, or equivalent coding certification required
Extensive knowledge of ICD-10-CM and CPT coding principles and guidelines
Knowledge of external auditing processes and third-party reviews
Knowledge of medical terminology, abbreviations, techniques and surgical procedures; anatomy and physiology; major disease processes; pharmacology; and the metric system
Knowledge of reimbursement systems, as well as federal, state and payer-specific regulations and policies pertaining to medical documentations, billing and coding; knowledge of subspecialty and surgical coding
Skill and ability to communicate effectively both orally and in writing
Skill and ability to research and analyze data, draw conclusions, and resolve issues
Skill and ability to read, interpret, and apply policies, procedures, laws, and regulations; read and interpret medical procedures and terminology; develop training materials; make group presentations; exercise independent judgment; and prepare reports and related documents
Skill and ability to maintain working relationships with physicians and other staff
Skill and ability to review the work of others and maintain confidentiality
Knowledge of Standards of Ethical Coding
Preferred
Coding Certificate program, AAPC or AHIMA accredited
Company
Grady Health System
Grady Health System is one of the largest public health systems in the United States
5001-10000 employees
H1B Sponsorship
Grady Health System has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (4)
2024 (7)
2022 (3)
2021 (5)
Funding
Current Stage
Late StageTotal Funding
$50M2014-09-29Grant· $50M
Leadership Team
L
Lindsay Caulfield
SVP/Chief Marketing & Experience Officer
S
Shannon Sale
Senior Vice President, Chief Strategy Officer
Recent News
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