University Hospitals

Pro Fee Denials/Follow-Up Coder

University Hospitals

full-time

Posted on:

Location Type: Hybrid

Location: Shaker Heights • Ohio • 🇺🇸 United States

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Job Level

JuniorMid-Level

About the role

  • Analyzes, on a daily basis and in accordance with established time frames, the outstanding insurance accounts
  • Initiates appropriate and effective telephone and/or written follow-up on the identified accounts
  • Communicates with payors and other internal departments as required to obtain critical information that impacts the resolution of both current and future claims
  • Researches and responds to all telephone inquiries from the customer service department, in a prompt, professional manner meeting departmental guidelines
  • Reviews and corrects coding edits and denials
  • May code ICD-10 from written documentation
  • May abstract CPT/HCPCS codes
  • May perform computer assisted coding functions
  • Consistently meets department productivity standards
  • Consistently meets department quality standards
  • Provides appropriate information and feedback to various personnel within UHPS
  • Supports and utilizes established departmental guidelines
  • Recommends additional research to other CBO departments
  • Identifies trends with insurance related issues and reports findings to the Team Lead
  • Acts as a role model for professionalism through appropriate conduct and demeanor at all times
  • Interprets written correspondence and either resolves the problem or forwards it to another department for prompt resolution
  • Effectively communicates utilizing the telephone, form letters or internal correspondence to resolve patient inquiries
  • Handles multiple tasks simultaneously
  • Must have an understanding of insurance products and billing requirements to effectively resolve discrepancies in billing statements
  • Performs other related duties as assigned

Requirements

  • High School Equivalent / GED (Required)
  • 2+ years of medical billing experience (Required)
  • Billing experience in a multi-specialty group is a plus (Preferred)
  • Excellent interpersonal skills to work in partnership with others to influence and gain cooperation (Required proficiency)
  • Ability to recognize, evaluates, and solves problems (Required proficiency)
  • Strong verbal and written communication skills (Required proficiency)
  • Extensive knowledge of the claims development process, as well as third party insurance program requirements (Required proficiency)
  • Must possess basic knowledge of ICD-9 and CPT coding (Required proficiency)
  • Ability to handle a variety of tasks with speed, attention to detail, and accuracy (Required proficiency)
  • Computer literate, experience with basic software packages
  • Certified Professional Coder (CPC) CPC-A, CPC-H, or CPC-P (Required)
  • Certified Coding Specialist (CCS) or CCS-P (Required)
  • Registered Health Information Technologist (RHIT) (Required)
  • Registered Health Information Administration (RHIA) (Required)
  • RCC (Preferred)
  • ROCC (Preferred)
Benefits
  • Maintains patient/physician confidentiality at all times
  • Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace
  • Complies with all policies and standards

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills
ICD-10 codingCPT codingHCPCS codingmedical billingclaims development processthird party insurance program requirementscomputer assisted codingbilling discrepancies resolutionattention to detailproblem solving
Soft skills
interpersonal skillsverbal communicationwritten communicationinfluencing skillscooperationprofessionalismmulti-taskingspeedaccuracyevaluating skills
Certifications
Certified Professional Coder (CPC)Certified Professional Coder - Apprentice (CPC-A)Certified Professional Coder - Hospital (CPC-H)Certified Professional Coder - Physician (CPC-P)Certified Coding Specialist (CCS)Certified Coding Specialist - Physician (CCS-P)Registered Health Information Technologist (RHIT)Registered Health Information Administration (RHIA)Revenue Cycle Certified (RCC)Revenue Cycle Operations Certified (ROCC)