University Hospitals

Medical Billing and Coding

• Under the direction of the Revenue Cycle Supervisor - Coding the Physician Coding Specialist II monitors and analyzes unresolved third party accounts for multi-specialty group practices.
• Analyzes outstanding insurance accounts on a daily basis and in accordance with established time frames.
• Initiates appropriate and effective telephone and/or written follow-up on the identified accounts.
• Communicates with payors and other internal departments to obtain critical information impacting claim resolution.
• Researches and responds to all inquiries from the customer service department in a prompt, professional manner.
• Reviews and corrects coding edits and denials.
• May code ICD-10 from written documentation and abstract CPT/HCPCS codes.
• May perform computer assisted coding functions.
• Consistently meets department productivity and quality standards.
• Maintains patient/physician confidentiality and effective communication with patients and physicians.
• Provides information and feedback to various personnel within UHPS.

Physician Coding Specialist II

• Responsible for accurately and timely coding of outpatient and professional medical records following established coding, CMS regulations and hospital guidelines.
• Reviews all types of encounters and accurately codes diagnostic and procedural information following coding guidelines and regulations information including, facility specific guidelines and federal regulations.
• Responsible for accurately coding hospital ancillary, ED, same day surgery, observation and/or professional physician services encounters.
• Maintains productivity and quality rate according to established standards.
• Ensures optimal CPT /ASC/APC/APG assessment.
• Understanding and ability to resolve coding specific edits such as CCI, LCD, NCD and MUE.
• Works within UH billing time frames.
• Maintains coding knowledge and skills via written coding resources, clinical information and educational webinars.
• Maintains knowledge of guidelines and regulations affecting the UHHS Coding Department.
• Maintains up to date credentials.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA).
• Participates in educational and informational activities.
• Performs other duties as assigned.
• Complies with all policies and standards.

Physician Coding Specialist II

Outpatient Coding Specialist I