Coding Denial Specialist (Surgical Coding) - Rev Cycle

UTHealth Houston•Houston, TX

7d•Remote

About The Position

RESTRICTED TO MMS/REVENUE CYCLE/CHARGE CAPTURE & CODING The Coding Denial Specialist is responsible for resolving denied claims within the Charge Capture/Coding department under the direction of the Manager, Charge Capture & Coding and the Director, Charge Capture & Coding. The Denial Specialist collaborates with members of the Revenue Cycle Management (RCM) team including Clinical Documentation Improvement (CDI) to identify trends and develop rejection prevention strategies. This position is responsible for providing feedback using reports and data to coding managers. The Coding Denial Specialist applies official coding guidelines, payer policies and established departmental policies and procedures to resolve claim rejections ensuring that timely filing deadlines have not been exceeded. Join UTHealth Revenue Cycle! We’re seeking an expert in surgical coding with a deep knowledge of payer policies and coding guidelines. Heavy focus on coding accuracy Experience with complex surgical coding claims Hybrid training (2–4 weeks), then fully remote(2- 4 weeks onsite for training, 1851 Crosspoint Ave, Houston, TX 77054) Must be able to attend any required onsite meetings Must live in Texas (TX). This is a Remote position, and you must reside in Texas We DO NOT provide lodging or mileage reimbursement for training

Requirements

Knowledge of ICD-10 CM and CPT coding conventions.
Proficiency in Microsoft Office suite, the ability to abstract data and maintain a database required.
Effective verbal and written communication between internal and external customers.
Excellent time management skills.
Ability to work collaboratively in a remote environment.
Registered Health Information Technician (RHIT) by American Health Information Management Association (AHIMA) required or
Certified Coding Specialist (CCS) by American Health Information Management Association (AHIMA) required or
Certified Coding Specialist Physician-based (CCS-P) by American Health Information Management Association (AHIMA) required or
Certified Professional Coder (CPC) by American Academy of Professional Coders (AAPC) required
High School Diploma or equivalent.
3 years of experience in a Health Information Management (HIM) multi-specialty coding.
Strong professional (pro-fee) coding experience in multi-specialty clinic, EPIC/IDX and Cerner EMR experience is preferred.
Employees must permanently reside and work in the State of Texas.

Nice To Haves

Associates degree in Health Information Management or related healthcare field is preferred.
May substitute required experience with equivalent years of education beyond the minimum education requirement.

Responsibilities

Performs timely and accurate review of coding related denials, appeal and submission, including tracking findings.
Addresses denied claims and performs research to resolve coding related rejections.
Reviews medical record and coded information to determine if coding needs to be changed or if an appeal is needed for resolution.
Monitors and tracks denial trends to help identify education/feedback opportunities.
Proactively monitors Revenue Cycle communications and payer websites for policy and guideline changes.
Responsible for reviewing underpayments in Rev Builder and resolving Claim Edits.
Reviews charge sessions that require resolution via claim system edits in IDX and EPIC.
Resolves edits per coding guidelines and department procedures.
Performs reviews to validate missed coding opportunities and participates in meeting to review findings and provide feedback to coding leadership for coding education opportunities.
Performs other Coding functions as appropriate, including assisting with coding backlogs as necessary.
Adheres to established productivity standards and maintains tracking tools.
Stays up-to-date with all federal, state and departmental coding guidelines and procedures.
Attends department meetings to discuss denial trends and prevention opportunities.
Performs other duties as assigned.

Benefits

100% paid medical premiums for our full-time employees
Generous time off (holidays, preventative leave day, both vacation and sick time – all of which equates to around 37-38 days per year)
The longer you stay, the more vacation you’ll accrue!
Longevity Pay (Monthly payments after two years of service)
Awesome retirement/pension plan
Free financial and legal counseling
Free mental health counseling services
Gym membership discounts and access to wellness programs
Other employee discounts including entertainment, car rentals, cell phones, etc.
Resources for child and elder care