Certified Coder (Hybrid) - Physicians Billing Service

Washington University in St. Louis • St. Louis, MO

2d • Hybrid

About The Position

Performs advanced coding and appeal activities; investigates payer issues; responsible for timely filing of appeals to insurance companies; handles charge corrections. This role involves creating appropriate letters and compiling documentation to substantiate the validity of claims, investigating and problem-solving reimbursement issues in collaboration with other coding staff and faculty, and working directly with physicians and other clinical staff as needed to provide documentation feedback and to develop appeals. The position requires researching payer policies and processes, reviewing clinical documentation in the medical record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patient's conditions and treatment, and working with coders and IBC staff with medical terminology and policy interpretation as required. Additionally, the role involves coding evaluation and management services to the appropriate CPT code level, ensuring ICD codes are linked appropriately to services provided, performing charge corrections when necessary, and working assigned Epic Work queues, CRM tasks, and reviewing remittance advice for rejections and accuracy of payment amounts as needed. The Certified Coder will also identify invoices that have been rejected per department criteria and perform accounts receivable (AR) functions in the Epic billing system, including updating insurance information and demographics. Special projects as assigned.

Requirements

• Must have one of the following coding credentials: AHIMA (CCA, CCS, or CCS-P); AAPC (CPC, CPC-A, CPC-H, CPC-H-A, or one of the AAPC specialty-specific coding credentials (the specialty-specific credential is only valid for that employee’s department)).

Nice To Haves

• Previous coding experience or experience equivalent to an associate’s degree in a related field.
• Knowledge of ICD-10 and CPT coding.
• Associate degree - Medical Coding & Billing

Responsibilities

• Responsible for appealing claims denied by third-party payers.
• Creates appropriate letters and compiles documentation to substantiate the validity of claims.
• Investigates and problem solves reimbursement issues in collaboration with other coding staff and faculty.
• Works directly with physicians and other clinical staff as needed to provide documentation feedback and to develop appeals.
• Researches payer policies and processes.
• Review clinical documentation in the medical record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patient's conditions and treatment.
• Works with coders and IBC staff with medical terminology and policy interpretation as required.
• Codes evaluation and management services to the appropriate CPT code level.
• Ensures ICD codes are linked appropriately to services provided.
• Responsible for charge corrections when necessary.
• Works assigned Epic Work queues, CRM tasks, and reviews remittance advice for rejections and accuracy of payment amounts as needed.
• Identifies invoices that have been rejected per department criteria.
• Perform accounts receivable (AR) functions in the Epic billing system, including updating insurance information, demographics.
• Special projects as assigned.

Benefits

• Up to 22 days of vacation, 10 recognized holidays, and sick time.
• Competitive health insurance packages with priority appointments and lower copays/coinsurance.
• Free Metro transit U-Pass for eligible employees.
• Defined contribution (403(b)) Retirement Savings Plan, which combines employee contributions and university contributions starting at 7%.
• Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians, and more!
• 4 weeks of caregiver leave to bond with your new child.
• Family care resources are also available for your continued childcare needs.
• Adult care resources.
• Covers the cost of tuition for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed