Properly codes Professional Inpatient, Physician outpatient and technical charges for multiple clinics to ensure accuracy and optimal reimbursement from all third-party payers. Essential Job Functions Works coding related charge review and claim edits daily to ensure timely and accurate billing. The Specialist should also research and resolve all coding related issues, and assists in meeting productivity and quality standards. Conducts the quality review of outpatient coding, assures coding comp... more details
Minimum Qualifications
High school diploma or equivalent and two years of medical billing or related experience, or related training from an accredited agency. The coder must be able to code & QA Outpatient Technical and Professional in 4 or more specialties. CCA, CCS, or CCSP coding certification from AHIMA, or CPCA, CPC, CPCHA coding certification from AAPC required within one year of hire. A successful completion of General Compliance Coder testing within 6 months of hire is also required.
Preferred Qualifications
PB/HB, Revenue Cycle, Coding, Charge Capture, Medicare, CMS Preferred.
Job Summary
Properly codes Professional Inpatient, Physician outpatient and technical charges for multiple clinics to ensure accuracy and optimal reimbursement from all third-party payers.
Essential Job Functions
- Works coding related charge review and claim edits daily to ensure timely and accurate billing. The Specialist should also research and resolve all coding related issues, and assists in meeting productivity and quality standards.
- Conducts the quality review of outpatient coding, assures coding compliance with federal regulations, and maintains up-to-date coding guidelines and coding policy changes.
- Reviews, interprets, and assigns diagnostic and procedural codes based upon medical record documentation according to correct coding principles. Provides skilled and specialized technical work in documentation and coding for medical billing, abstracts complex patient-related data from medical records and coding of diagnoses and procedures using ICD-9 and CPT codes.
- Work all WQ PB/HB errors daily
- Educate and offer feedback to physicians and staff as needed to ensure that documentation is complete, accurate, and compliant with guidelines.
- Maintain acceptable productivity level and keep Pre/AR at or below departmental standard.
- Actively participate in team functions such as team meetings, educational sessions, and team projects.
- Adheres to internal controls and reporting structure.
Working Environment
Standard hospital, clinical, laboratory and/or office environments.
Equal Employment Opportunity
UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a VEVRAA Federal Contractor, UTMB Health takes affirmative action to hire and advance women, minorities, protected veterans and individuals with disabilities.
