Job Description

Job Description

Responsibilities

The Coder provides coding services and support to assigned IPM Markets/Billing Entities, as required, utilizing clinical documentation in multiple electronic health record (EHR) systems. Applies working knowledge of medical terminology, anatomy, CPT-4 and ICD-10 codes and coding skills/ experience to ensure timely and accurate coding of clinical documentation. Meets or exceeds established performance targets (productivity and quality) established by the Coding Manager. Works closely with the Billing Department to ensure accuracy in charge posting to the Practice Management System (PMS). Effectively communicates with providers and market staff to ensure that clinical documentation is completed and signed to avoid coding delays and minimize lag days. Assists in educating providers on clinical documentation requirements to support their coding and ensure all coding (charge) possibilities are being captured. Timely notification to the appropriate CBO individuals to review coding for new procedures and initiate PMS set-up (to include fees). Demonstrates the ability to be an effective team player. Upholds best practices in day to day processes and work flow standardization to drive maximum efficiencies across the team.

* Provides accurate and timely coding services and support to assigned IPM Markets, as required, utilizing clinical documentation in multiple electronic health record (EHR) systems. Meets or exceeds established performance targets (productivity and quality) established by the Manager, Coding Integrity and Audits.
* Performs effective reconciliation to ensure that all charges are captured and works closely with the Charge Capture and Insurance Billing Operations Department to ensure accuracy in charge posting to the Practice Management System (PMS).
* Timely communication with providers and market staff to ensure that medical record documentation is completed and signed to avoid coding delays, minimize lag days and meet team goals/objectives
* Assists in educating providers on clinical documentation requirements to support their coding and ensure all coding (charge) possibilities are being captured. Timely notification to the appropriate CBO individuals to review coding for new procedures and initiate PMS set-up (to include fees).
* Maintains an expanded knowledge base CPT-4 and ICD-10 codes, government, managed care and third party billing guidelines, AMA, AAP, CMS and coding policies. Meets continued education guidelines to maintain current AAPC CPC certification.
* Exercises good judgement in escalating identified coding trends that may negatively impact productivity, quality or revenue to mitigate claim denials, expedite reprocessing of claims and maximize opportunities to enhance front end, coding-related claim edits to facilitate first pass resolution.
* Participates in regularly scheduled team meetings offering new paths, procedures and approaches to maximize opportunities for performance and process improvement.

Qualifications

Education: High School Graduate/GED required. Technical School/2 Years College/Associates Degree preferred.

Work experience: Experience (3-5 years minimum) working in a healthcare (professional) billing, health insurance, coding or equivalent operations work environment. AAPC CPC Certification required.

Knowledge: Healthcare (professional) billing, CPT-4 and ICD-10 codes, government, managed care and third party billing guidelines, AMA, AAP, CMS and coding policies. Understanding of the revenue cycle and how the various components work together preferred.

Skills: Excellent organization skills, attention to detail, research and problem solving ability. Results oriented with a proven track record of accomplishing tasks within a high-performing team environment. Service-oriented/customer-centric. Strong computer literacy skills including proficiency in Microsoft Office.

Abilities:

Equipment Operated: Mainframe billing software (e.g., Cerner, Epic, IDX) experience highly desirable.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Notice

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