Outpatient/Provider Coder III

University of Utah Health•Salt Lake City, UT

About The Position

This position abstracts, codes, and interprets outpatient clinic and provider services for professional and/or facility billing. It uses coding expertise to abstract and record data from medical records and supports documentation and coding-related areas. The role codes and charges complex or specialty services and may serve as a resource for other coders. It does not provide patient care. University of Utah Health is a patient-focused organization dedicated to enhancing health and well-being through patient care, research, and education. It promotes collaboration, excellence, leadership, respect, compassion, innovation, responsibility, integrity, quality, and trust. The University of Utah is a Level 1 Trauma Center, and its hospitals and clinics provide comprehensive services, medical advancement, and patient care.

Requirements

AHIMA- or AAPC-recognized certification, such as CCA, CPC, COC, CPC-H, CPC-P, CCS, CCS-P, RHIA, RHIT, or another specialty certification indicated by the department.
Three years of coding, clinical, or billing experience.
Demonstrated potential ability to perform the essential functions of the position.
Demonstrated leadership, human relations, and effective communication skills.
Knowledge of clinical documentation requirements related to regulatory and reimbursement rules and regulations, and health insurance processing.
Proficiency with computer software, such as Microsoft Word and Excel.
Ability to maintain certifications through continuing education credits.
Ability to effectively train others.
Knowledge of CMS, AMA, and AHA coding and billing guidelines.

Nice To Haves

Experience organizing and conducting coding or billing education.

Responsibilities

Perform final reconciliation on clinic or provider visits and resolve missing, incomplete, or inconsistent documentation by contacting appropriate personnel.
Review, abstract, and code multiple or subspecialty services and complex or unusual cases, assigning appropriate coding classifications.
Serve as a resource to coding staff, the business office, providers, hospital staff, clinic managers, and other clinical personnel on billing-related issues.
Research and resolve high-volume accounts, complex or escalated suspended claims, and compliance issues using appropriate databases, and share findings with coding staff.
Research, interpret, and apply regulatory guidelines to coding and reimbursement decisions, and educate staff on related guidelines and resolutions.
Assist in the auditing process.
Train Level I and II coders and potentially serve as a project lead.
Assist with backlog to maintain department quality and productivity standards.
Assist with other department coding needs as requested.
Potentially participate in committees and work groups.
Potentially present information to providers and assist with training on coding and billing.