EDUCATION & EXPERIENCE:
Minimum Qualifications:
- Two years of medical billing or related experience, or related training from a non-accredited program or accredited agency.
Preferred Qualifications:
- Outpatient women's and pediatric coding experience preferred.
- Knowledge of coding guidelines, anatomy and physiology, biology and microbiology, medical terminology and medical abbreviations.
REQUIRED LICENSES, REGISTRATIONS, OR CERTIFICATIONS:
One of the following:
- CCA - Certified Coding Associate (AHIMA) or
- CCS - Certified Coding Specialist (AHIMA) or
- CCS-P - Certified Coding Specialist - Physician Based (AHIMA) or
- RHIA - Registered Health Information Administrator (AHIMA) or
- RHIT - Registered Health Information Technician (AHIMA)
- CIC - Certified Inpatient Coder (AAPC) or
- COC - Certified Outpatient Coder (AAPC) or
- CPC - Certified Professional Coder (AAPC) or
- CPC-A - Certified Professional Coder - Apprentice (AAPC) or
- CRC - Certified Risk Adjustment Coder (AAPC)
JOB SUMMARY:
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.
ESSENTIAL JOB FUNCTIONS:
- 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 CEU's 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 DNB's 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.
Marginal or Periodic Functions:
- Performs related duties as required.
KNOWLEDGE/SKILLS/ABILITIES:
- Strong written and oral communication skills.
WORKING ENVIRONMENT/EQUIPMENT:
- Standard office environment at UTMB's main campus or other location.
- Occasional travel may be required.
- Standard office equipment
SALARY RANGE:
Actual salary commensurate with experience.
WORK SCHEDULE:
Remote, Monday through Friday, Full-Time Position.
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.
Compensation