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. Position Summary and Purpose This employee is responsible for reviewing and evaluating medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM and HCPCS/CPT codes for services provided at the Brown Cancer Center (BCC) including Bone Marrow Transplant (BMT) and infusions and injections (I&I) and clinic charges. The specialist performs code validation across multiple entities and applies the appropriate coding guidelines and criteria for code and modifier selections. The specialist adheres to the Official CMS Coding Guidelines and Facility Coding Compliance policies and procedures for the assignment of complete, accurate, timely, and consistent codes for charge entry. The specialist supports the facility’s overall operational goals by efficiently and effectively providing account data needed for accurate and timely Revenue Cycle processing and billing. Essential Functions: • Uses ICD-10-CM and/or HCPCS/CPT codes to assign, validate, and/or work pre-bill coding edits for the following patient types: • Medical Oncology (Med-ONC), Radiation Oncology (Rad-ONC), Bone Marrow Transplant (BMT), Infusion & Injections, and multispecialty hospital-based outpatient clinics (Oncology, HepC, MS, Pulmonary, etc.) • Works pre-bill edits daily to resolve issues related to coding assignments, charge errors, and missed modifiers • Maintains or exceeds established productivity standard (minimum of 75 pre-bill edits cleared daily or a combination of daily charge capture and pre-bill edits) • Ensures that all assigned charges are captured timely and consistently within the 3-day charge goal • Performs coding audits for BCC coders upon request and as needed to reduce coding error trends • Utilizes the complete medical record documentation in code assignment, validation, and/or editing of codes Other Functions: • Works collaboratively and supports efforts of team members • Ensures adherence to the official coding guidelines, infusion and injection coding guidelines, ethical coding standards as well as HIM coding compliance policies and procedures • Meets all educational requirements and attend required continuing education workshops, webinars assigned by manager for coding compliance • 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 Description: Job Requirements (Education, Experience, Licensure and Certification) Education: • High school diploma or GED/Equivalent (required) • Completion of a Certified Coding Program (required) Experience: • Three (3) years outpatient coding experience (required) • Three (3) years of prior oncology coding experience (preferred) • Prior billing to include government and commercial payer experience (preferred) • Prior experience with 3M Coding and Allscripts STAR and TruBridge billing systems (preferred) Certification: • Nationally accepted Certified Coding Credentials (RHIT, RHIA, CPC, CPC-H, CCA, CCS, CCS-P or CHONC) (required) Job Competency: Knowledge, Skills, and Abilities critical to this role: • Working knowledge of medical terminology, anatomy, and physiology • Demonstrates a working knowledge of Infusion & Injections and Oncology Billing • Working knowledge of Official CMS Coding Rules and Guidelines, ethical coding standards as well as HIM coding compliance policies and procedures • Ability to complete project assignments in a timely manner and identify trends in charge reconciliation data Language Ability: • Must be able to communicate effectively in both verbal and written formats Reasoning Ability: • Ability to break down problems or tasks; using prior knowledge and experience to identify causes and consequences of events Computer Skills: • Demonstrates strong Microsoft Office knowledge skills • Demonstrates strong coding skills; knowledge of 3M Coding and Allscripts STAR and TruBridge billing systems, preferred Additional Responsibilities: • 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 UofL Health is a fully integrated regional academic health system with nine hospitals, four medical centers, Brown Cancer Center, Eye Institute, nearly 200 physician practice locations and more than 1,000 providers in Louisville and the surrounding counties, including southern Indiana. Additional access to UofL Health is provided through a partnership with Carroll County Memorial Hospital. With more than 14,000 team members – physicians, surgeons, nurses, pharmacists and other highly-skilled health care professionals, UofL Health is focused on one mission: to transform the health of communities we serve through compassionate, innovative, patient-centered care. Please login into Workday and search for Job Hub.
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Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED