As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Reviews codes for accuracy in accordance with coding rules and policies. Responsible for system edit reviews and follows up on insurance coding denials for resolution. ESSENTIAL FUNCTIONS Uses knowledge of coding systems and system logic to review codes created by electronic charge capture and/or assigns codes through medical record documentation as per designated workflow. Completes system edit reviews to make corrections before transmittal. Troubleshoots problems that prevent claims from being released. Identifies cause of edit and independently resolves issue by reviewing the patient encounter to understand the nature of the problem. Provides feedback for correction and follow-up. May abstract data and review codes for accuracy. Ensures accurate reimbursement based on guidelines and/or abstraction of provider documentation. Responds to coding information requests and inquiries from various sources. Consults with internal customers and external vendors to obtain greater specificity and/or clarification when documentation appears inconsistent or incomplete. Other duties as assigned.
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Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED