Coding Representative - Coding Denial Follow-Up Team (CDFT) - Physician Hospital Accounts Receivable Management (PHARM) - Patient Financial Services (PFS)

UIOWA•Iowa City, IA

5d•Remote

About The Position

The University of Iowa Health Care department of Patient Financial Services is seeking a Coding Representative for an entry-level financial and insurance related position in the healthcare industry. In this role, you will review coding denials and determine if you need to assign new ICD-10 codes and CPT codes for professional outpatient services and professional inpatient services. The Coding Denial Follow Up Team (CDFT) Medical Coder will provide exceptional customer service to our external customers: patients, insurance contacts, etc; as well as internal customers. You will support our “Service Excellence” standards to all our customer groups, utilize tools and processes to make independent decisions and you will maintain integrity and treat internal and external customers respectfully. This position is eligible to participate in remote work and applicants who wish to work remotely will be considered. Training will be held either ONSITE or via ZOOM from the HSSB building at a length determined by the supervisor. Remote eligibility will be evaluated upon a satisfactory job training opportunity. Successful candidates must comply with requirements of the remote work program and related policies.

Requirements

Bachelor’s degree; or equivalent combination of education and experience.
Certification as RHIT, RHIA, CPC, CCS, CCSP, or equivalent through a nationally recognized credentialing body such as AHIMA or AAPC.
Related customer service experience (typically 6 months or more) in a professional, financial, health care or medical related environment.
Strong attention to detail with a proven ability to gather and analyze data and keep accurate records.
Proficiency with computer software applications, i.e. Microsoft Office Suite (Excel, Word, Outlook, PowerPoint) or comparable programs and an ability to quickly learn and apply new systems knowledge.
Demonstrated ability to handle complex and ambiguous situations with minimal supervision.
Self-motivated with initiative to seek out additional responsibilities, tasks and projects.
Medical terminology knowledge.
Basic knowledge and understanding of HIPAA laws and regulations.

Nice To Haves

1-3 years’ experience with medical coding and/or billing preferred, will consider applicants with less experience.
Knowledge, understanding and/or experience with CMS regulations or industry standards.
Knowledge of anatomy and physiology.
Experience maintaining professionalism while handling difficult situations with callers or customers.
Demonstrated ability to maintain or improve established productivity and quality requirements.
Basic knowledge of healthcare billing (healthcare revenue cycle); insurance, and/or federal and state assistance programs.

Responsibilities

Review medical records to assign CPT/HCPCS and/or ICD-10-CM/PCS diagnosis and procedure codes consistent with coding compliance policies, ICD-10-CM/PCS Official Coding Guidelines and regulatory guidelines.
Monitor compliance/coding standards and policies to ensure UI Health Care receives full and accurate reimbursement for services that comply with HIPAA as well as coding and payment rules/regulations.
Resolve claims from an assigned work-queue to ensure that all claims are worked within the timely filling/appeal guidelines.
Determine if appropriate payment has been made by various entities; and/or work with patients and insurance companies, government entities (such as Centers for Medicare and Medicaid Services) to obtain correct payments; and/or appeal claim payments/denials.
Perform denial management, research, obtain proper documentation to support resolution of overpayment; resolving credit balances and to resolve outstanding accounts
Be expected to maintain a high-level of accuracy to meet productivity and quality requirements.
Identify trends and/or work processes for potential process improvements.
Review and analyze report data to provide status updates to leadership.
Communicate with providers, payers, patients, internal departments, co-workers and Coordinator’s to resolve issues.
Communicate changes in payor policies and denial trends; e scalates claim payment delays as appropriate.