About UofL Health: UofL Health is a fully integrated regional academic health system with five hospitals, four medical centers, nearly 200 physician practice locations, more than 700 providers, the Frazier Rehab Institute and Brown Cancer Center. With more than 12,000 team members—physicians, surgeons, nurses, pharmacists and other highly skilled health care professionals—UofL Health is focused on one mission: delivering patient-centered care to each and every patient each and every day.
and Purpose The Coder II is responsible for abstracting and assigning valid CPT, ICD-10, HCPCs and modifiers to ensure appropriate reimbursement in accordance with federal, state, and private health plans as well as organization and regulatory guidance. This position is responsible for identifying compliance concerns, trends, and education opportunities to ensure proper coding, documentation, and accuracy of billing within their areas or responsibility/specialty.
The Coder II will work independently with limited oversight and may require direction from supervisor or more senior co-workers on complex cases. Responsible for coding surgical procedures in accordance with the Coding Guidelines for Surgical Procedures. Proper use of modifiers in surgical coding.
- Accurately abstracts information from the service documentation, assigns appropriate CPT, ICD-10, HCPCs codes into the appropriate billing systems, ensuring compliance with established guidelines
- Identifies and communicates deficiencies that impact the billing process
- Completes encounters in the coding work queue or reports in a timely manner
- Identifies trends and educational opportunities to ensure proper coding, documentation, and accuracy of billing within areas of responsibility/specialty
- Reviews and resolves denials
- Ensures documentation meets current EM Guidelines for Providers
- Ensures documentation meets Teaching Physician Rules as mandated by the Center for Medicare and Medicaid Services (CMS) and UofL Health policies prior to release of a code for billing
- Ensures documentation for Advanced Practice Providers meets payer specific rules prior to release of a code for billing
- Provides comments/suggestion relative to weak areas identified in the coding reviews
- Provides trending deficiencies to Senior Manager and Compliance Educator, as appropriate
- Assists Coder Lead or Supervisor in training and mentoring staff. Other Functions:
- Communicates professionally with providers, practice management, and other stake holders either verbally or in writing
- Meets or exceeds organization coding production and quality standards
- Participates in special projects and completes duties as assigned
- Develop daily/weekly communication with office managers, department, and providers.
- Responds in a timely manner to questions from manager, providers, department, and representative
- Maintains compliance with rules and regulations regarding coding
- Ability to work within a team environment and meet monthly goals
- Maintains compliance with all company policies, procedures and standards of conduct
- Complies with HIPAA privacy and security requirements to maintain confidentiality at all times
- Performs other duties as assigned Additional
Job Requirements (Education, Experience, Licensure and Certification)
• High school diploma or GED/equivalent (required)
- Three (3) years of coding experience (required)
- Previous Electronic Health Record Experience (preferred) Certification:
- Certified Professional Coder (CPC) accredited by the American Academy of Professional Coders (AAPC) (required)
- Certified Coding Specialist (CCS) or Certified Coding Specialists Based (CCS-P) accredited by the American Health Information Management Association (AHIMA) (required) Job Competency: Knowledge, Skills, and Abilities critical to this role:
- Advanced knowledge of medical codes involving selections of most accurate and description code using the ICD 10, CPT, HCPC, and IHS coding conventions
- Understands and applies regulatory changes and stays current with coding updates, including NCCI and MUE edits.
- Advanced working knowledge of anatomy and physiology, disease process and medical terminology
- Advanced knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes Ability to work independently with little oversight Language Ability:
- Must be able to able to communicate effectively, demonstrating a high level of professionalism in all communications
- Proper grammar, spelling, punctuation and composition expected in correspondence and report preparation Reasoning Ability:
- Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists
- Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form Computer
• Must be proficient with Microsoft, Google Chrome, Internet navigation, and database management • Able to adapt to new technologies Additional
- Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times
- Maintains confidentiality and protects sensitive data at all times
- Adheres to organizational and department specific safety standards and guidelines
- Works collaboratively and supports efforts of team members
- Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff and the broader health care community UofL Health Core Expectation: At UofL Health, we expect all our employees to live the values of honesty, integrity and compassion and demonstrate these values in their interactions with others and as they deliver excellent patient care by:
- Honoring and caring for the dignity of all persons in mind, body, and spirit
- Ensuring the highest quality of care for those we serve
- Working together as a team to achieve our goals
- Improving continuously by listening, and asking for and responding to feedback
- Seeking new and better ways to meet the needs of those we serve
- Using our resources wisely
- Understanding how each of our roles contributes to the success of UofL Health