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Physician Coding Specialist II
University HospitalsPhysician Coding Specialist II for multi-specialty group practices analyzing unresolved insurance accounts for prompt resolution. Ensure timely payments on outstanding claims through effective communication and follow-up.
About the role
Key responsibilities & impact- 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.
- Working knowledge of coding rules and payer guidelines.
- Consistently meets department productivity standards.
- Consistently meets department quality standards.
- Maintains patient/physician confidentiality at all times and maintains effective communication and professional interaction with patients and physicians.
- 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
What you’ll need- Education High School Equivalent / GED (Required)
- Work Experience 2+ years Of medical billing experience (Required) and 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.
- Licenses and Certifications Certified Professional Coder (CPC) CPC-A, CPC-H, or CPC-P (Required) or Certified Coding Specialist (CCS) or CCS-P (Required) or Registered Health Information Technologist (RHIT) (Required) or Registered Health Information Administration (RHIA) (Required) RCC (Preferred) or ROCC (Preferred)
Benefits
Comp & perks- Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients.
- Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.
ATS Keywords
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Hard Skills & Tools
ICD-10 codingCPT codingHCPCS codingcomputer assisted codingclaims development processbilling requirementscoding editsdenials resolutioninsurance account analysismulti-tasking
Soft Skills
interpersonal skillsproblem-solvingverbal communicationwritten communicationattention to detailprofessionalismteam collaborationcustomer serviceeffective communicationtime management
Certifications
Certified Professional Coder (CPC)CPC-ACPC-HCPC-PCertified Coding Specialist (CCS)CCS-PRegistered Health Information Technologist (RHIT)Registered Health Information Administration (RHIA)RCCROCC