Minimum Qualifications:
A high school diploma or GED and three years of multi-specialty coding experience. The senior coder must be proficient in coding Professional services, and/or Outpatient professional and hospital technical services. Must also have experience with communicating, training, and educating providers in proficiency. Knowledge of coding guidelines, anatomy and physiology, biology and microbiology, medical terminology and medical abbreviations is a plus.
Licenses, Registrations, or Certifications:
CCA – Certified Coding Associate American Health Information Management (AHIMA) Or
CCS – Cert-Cert Coding Specialist American Health Information Management (AHIMA) Or
CCS-P – Cert-CCS-P Physician Based American Health Information Management (AHIMA) Or
RHIA – Cert-Reg Health Inform. Admins American Health Information Management (AHIMA) Or
RHIT – Cert-Reg Health Inform. TECH American Health Information Management (AHIMA) Or
CIC – Certified Inpatient Coder American Academy of Professional Coders (AAPC) Or
COC – Certified Outpatient Coder American Academy of Professional Coders (AAPC) Or
CPC – Cert-Cert Professional Coder American Academy of Professional Coders (AAPC) Or
CPC-A – Cert Prof Coder – Apprentice American Academy of Professional Coders (AAPC) Or
CRC – Cert Risk Adjustment Coder American Academy of Professional Coders (AAPC)
*One of the above certifications is required.
Job Summary/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.
Job Duties:
• 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.
Knowledge/Skills/Abilities:
Strong written and oral communication skills
Salary Range:
Actual salary commensurate with experience or range if discussed and approved by hiring authority.
Work Schedule:
Remote position. 8am to 5pm, and as needed on occasion.
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.