Physician Coding Specialist I Remote

University Hospitals•Cleveland, OH

4d•Remote

About The Position

The Physician Coding Specialist I monitors and analyzes unresolved third-party accounts for multi-specialty group practices under the direction of the Revenue Cycle Supervisor - Coding. The role initiates contact and negotiates appropriate resolutions to ensure timely payment of outstanding claims. It involves reviewing and correcting coding edits and denials, and may include coding ICD-10 from written documentation. The position requires an understanding of insurance products and billing requirements to resolve billing discrepancies, while meeting departmental productivity and quality standards. The specialist communicates with payors, internal departments, patients, physicians, and customer service staff to obtain information and resolve account or billing inquiries. The role also identifies insurance-related trends, shares findings with the Team Lead, and maintains patient and physician confidentiality. This position regularly involves access to Protected Health Information (PHI) and requires compliance with applicable training, codes of conduct, policies, and procedures. The position is remote and has a stated travel requirement of 10%25.

Requirements

High school equivalent or GED.
Required certification: Certified Professional Coder (CPC), CPC-A, CPC-H, or CPC-P; or Certified Coding Specialist (CCS), RCC, or ROCC; or Registered Health Information Technologist (RHIT); or Registered Health Information Administration (RHIA).
Excellent interpersonal skills to work in partnership with others and influence and gain cooperation.
Computer literacy and experience with basic software packages.
Basic knowledge of ICD-9 and CPT coding.
Ability to recognize, evaluate, and solve problems.
Strong verbal and written communication skills.
Extensive knowledge of the claims development process and third-party insurance programs.
Ability to handle a variety of tasks with speed, attention to detail, and accuracy.
Ability to understand insurance products and billing requirements to resolve discrepancies in billing statements.

Nice To Haves

At least one year of medical billing experience in a multi-specialty practice.

Responsibilities

Analyze outstanding insurance accounts daily and follow up by telephone or in writing within established time frames.
Communicate with payors and internal departments to obtain information affecting current and future claims.
Research and respond promptly and professionally to telephone inquiries from the customer service department, in accordance with departmental guidelines.
Review and correct coding edits and denials.
Code ICD-10 from written documentation when needed.
Meet minimum departmental productivity and quality standards.
Maintain patient and physician confidentiality and communicate and interact professionally with patients and physicians.
Provide information and feedback to personnel within UHPS, follow departmental guidelines, and recommend additional research to other CBO departments.
Identify trends in insurance-related issues and report findings to the Team Lead.
Interpret written correspondence and resolve the issue or forward it to another department for prompt resolution.
Communicate by telephone, form letters, or internal correspondence to resolve patient inquiries.
Handle multiple tasks simultaneously.
Perform other assigned duties and comply with applicable policies and standards.
Safely and securely maintain Protected Health Information (PHI).