Coding Representative (CDFT) - Physician/Hospital Accounts Receivable Management (P/HARM) - PFS

Coding Representative (CDFT) - Physician/Hospital Accounts Receivable Management (P/HARM) - PFS

University of Iowa Health Care's department of Patient Financial Services is seeking a Coding Representative for an entry-level financial and insurance related position in the healthcare industry. In this role, you will review coding denials and determine if you need to assign new ICD-10 codes and CPT codes for professional outpatient services and professional inpatient services. The Coding Denial Follow Up Team (CDFT) Medical Coder will provide exceptional customer service to our external customers: patients, insurance contacts, etc; as well as internal customers. This position is eligible to participate in remote work and applicants who wish to work remotely will be considered. Training will be held either ONSITE or via Hybrid (Inhouse/Zoom) from the HSSB building at a length determined by the supervisor. Remote eligibility will be evaluated upon a satisfactory job training opportunity. Per policy, work arrangements will be reviewed annually and must comply with the remote work program and related policies and employee travel policy when working at a remote location. University of Iowa Health Care recognized as one of the best hospitals in the United Statesis Iowa's only comprehensive academic medical center and a regional referral center. Each day more than 12,000 employees, students, and volunteers work together to provide safe, quality health care and excellent service for our patients. Simply stated, our mission is: Changing Medicine. Changing Lives. WE CARE Core Values: Welcoming - We have an environment where everyone has a voice that is heard; that promotes the dignity of our patients, trainees, and employees; and allows all to thrive in their health, work, research, and education. Excellence - We achieve and deliver our personal and collective best in the pursuit of quality and accessible health care, education, and research. Collaboration - We collaborate with health care systems, providers, and communities across Iowa and the region as well as within our UI community. We believe teamworkguided by compassionis the best way to work. Accountability - We behave ethically, act with fairness and integrity, take responsibility for our own actions, and respond when errors in behavior or judgment occur. Respect - We create an environment where every individual feels safe, valued, and respected, supporting the well-being and success of all members of our community. Empowerment - We commit to fair access to research, health care, and education for our community and opportunities for personal and professional growth for our staff and learners. Position Responsibilities: Review medical records to assign CPT/HCPCS and/or ICD-10-CM/PCS diagnosis and procedure codes consistent with coding compliance policies, ICD-10-CM/PCS Official Coding Guidelines and regulatory guidelines. Monitor compliance/coding standards and policies to ensure UI Health Care receives full and accurate reimbursement for services that comply with HIPAA as well as coding and payment rules/regulations. Resolve claims from an assigned work-queue to ensure that all claims are worked within the timely filling/appeal guidelines. Determine if appropriate payment has been made by various entities; and/or work with patients and insurance companies, government entities (such as Centers for Medicare and Medicaid Services) to obtain correct payments; and/or appeal claim payments/denials. Perform denial management, research, obtain proper documentation to support resolution of overpayment, resolving credit balances and to resolve outstanding accounts receivable by interacting with third-party entities via websites, telephone, or written inquiries. Identify & report undesirable trends and reimbursement modeling errors or underlying causes of incorrect payment; review allowed variances from third party payers. Be expected to maintain a high-level of accuracy to meet productivity and quality requirements. Identify trends and/or work processes for potential process improvements. Review and analyze report data to provide status updates to leadership. Communicate with providers, payers, patients, internal departments, co-workers and Coordinator's to resolve issues. Communicate changes in payor policies and denial trends; escalates claim payment delays as appropriate. Classification Title: Coding Representative (CDFT) Department: Patient Financial Services (PHARM) Percent of Time: 100% Schedule: Monday - Friday Pay Grade: 2B Location: Hospital Support Services Building (HSSB)