Senior Coder - RCO Coding (Remote)

EDUCATION & EXPERIENCE:

Minimum Qualifications:

• Three years of multi-specialty coding experience.
• Proficient in coding Professional services, and/or Outpatient professional and hospital technical services.
• Experience with communicating, training, and educating providers in proficiency.

Preferred Qualifications:

• Three (3) or more years of hands-on experience in professional medical billing, with demonstrated knowledge of charge review, claim edits, and rejection/denial workflows.
• Demonstrated knowledge of ED/OBS infusion coding.
• 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.