Role Description
Properly codes and/or audits professional services for Inpatient and/or professional and hospital outpatient technical services for multiple specialty areas to ensure accuracy and optimal reimbursement from all third-party payers.
-
Reviews documentation in EPIC and/or on paper as provided to appropriately assign ICD-10-CM, PCS and CPT codes.
-
Communicates with and provides feedback to the education team and/or provider for query opportunities for documentation clarification or missing elements in the medical record.
-
Utilizes the encoder and/or Optum software to correctly assign all appropriate ICD-10-CM, ICD10-PCS and CPT codes for diagnosis and procedures.
-
Sequences diagnoses and procedures to generate clean claims in accordance with the Coding Guidelines based on the type of coding being reviewed.
-
Verifies all ADT information is correct on all charge sessions; date of service, billing provider, service provider, place of service, referral information and claim form if required.
-
Attends and participates in coding education sessions.
-
Obtains required CEUβs for certification and completes any required education.
-
Works coding related charge reviews/claim edits daily to ensure timely and accurate billing within filing deadlines.
-
The coder is responsible for productivity and quality standards to adhere with coding compliance and federal regulations.
-
Work all PB/HB claim edits and reject errors daily.
-
Hospital DNBβs will be worked as assigned per Specialty.
-
Work charge reconciliation to ensure all services provided are captured for coding in a timely manner.
-
Adheres to internal controls and reporting structure.
Qualifications
-
Two years of medical billing or related experience, or related training from a non-accredited program or accredited agency.
-
Experience with Outpatient E/M level coding preferred.
-
Knowledge of coding guidelines, anatomy and physiology, biology and microbiology, medical terminology and medical abbreviations.
Requirements
-
One of the following certifications is required:
-
CCA β Certified Coding Associate (AHIMA)
-
CCS β Certified Coding Specialist (AHIMA)
-
CCS-P β Certified Coding Specialist β Physician Based (AHIMA)
-
RHIA β Registered Health Information Administrator (AHIMA)
-
RHIT β Registered Health Information Technician (AHIMA)
-
CIC β Certified Inpatient Coder (AAPC)
-
COC β Certified Outpatient Coder (AAPC)
-
CPC β Certified Professional Coder (AAPC)
-
CPC-A β Certified Professional Coder β Apprentice (AAPC)
-
CRC β Certified Risk Adjustment Coder (AAPC)
Working Environment/Equipment
-
Standard office environment at UTMBβs main campus or other location.
-
Occasional travel may be required.
-
Standard office equipment.
Work Schedule
-
Remote Position, Monday through Friday, 8-hour shifts with availability between 6 AM - 6 PM.
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 Federal Contractor, UTMB Health takes affirmative action to hire and advance protected veterans and individuals with disabilities.